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Zamir H, Ahmad B, Ali S, Khan SA, Sarwar R, Khan A, Ali J, Khan AA. Molecular characterization of Mycobacterium tuberculosis through MPT64 gene polymorphism using next-generation sequencing technology. Future Microbiol 2022; 17:763-772. [PMID: 35473398 DOI: 10.2217/fmb-2020-0231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To characterize and analyze polymorphism of the MPT64 gene and evaluate AgMPT64-based immunochromatographic assay (ICA) specificity associated with polymorphism. Materials & methods: A total of 1449 suspected samples were tested for tuberculosis (TB), and the MPT64/rv1980c gene was sequenced using next-generation sequencing for polymorphism analysis. Results: Of the TB-positive individuals, 200 (13.80%), 186 (12.84%) and 129 (8.90%) were positive using the liquid culture, GeneXpert and fluorescence microscopy assays, respectively. Liquid culture medium-based samples were confirmed using ICA, in which 193 (96.5%) were positive while seven (3.5%) were negative. Out of 14 sequenced samples, seven were positive and seven negative; 13 were identical to the reference and just one (ICA positive) showed a C477A point mutation (F159L). Conclusion: The results indicate that AgMPT64 can be considered as a potent vaccine candidate.
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Affiliation(s)
- Hina Zamir
- Centre of Biotechnology & Microbiology, University of Peshawar, KP, 25120, Pakistan
| | - Bashir Ahmad
- Centre of Biotechnology & Microbiology, University of Peshawar, KP, 25120, Pakistan
| | - Sajid Ali
- Provincial Tuberculosis Reference Laboratory, Peshawar, KP, 25120, Pakistan
| | - Saad A Khan
- Department of Medicine, Kabir Medical College, Peshawar, KP, 25120, Pakistan
| | - Raheela Sarwar
- Centre of Biotechnology & Microbiology, University of Peshawar, KP, 25120, Pakistan
| | - Alamzeb Khan
- Department of Pediatrics, Yale school of Medicine, Yale University, New Haven, CT 06511, USA
| | - Johar Ali
- Centre for Genomics Sciences, Rehman Medical Institute, Peshawar, KP, 25120, Pakistan
| | - Abid A Khan
- Centre of Biotechnology & Microbiology, University of Peshawar, KP, 25120, Pakistan.,Centre for Genomics Sciences, Rehman Medical Institute, Peshawar, KP, 25120, Pakistan.,Department of Chemical Sciences, University of Lakki Marwat, Lakki Marwat, KP, 28420, Pakistan
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2
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The Key Organizational Factors in Healthcare Waste Management Practices of Libyan Public Hospitals. SUSTAINABILITY 2021. [DOI: 10.3390/su132212785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aims to investigate factors contributing to healthcare waste management practices among Libyan public hospitals. The organizational culture and structure are proposed to have their effect upon hospital organizational units in charge of healthcare waste production by a theoretical review to develop two main hypotheses. Hence, this study used the stratified random sampling technique to select respondents such as top management officials, heads of departments, and administrators who work in all the hospitals located in the south of Libya, from whom data was collected. The data for the study was gathered via a survey questionnaire from Libyan public hospitals in the country’s southern region. A total of 210 questionnaires were distributed and 171 usable responses were received, yielding a 70% response rate. Though the findings of the study show some inconsistency, the two dimensions of the culture examined in this study are found to have a positive relationship and significant influence on the management practices of health waste. Besides, it shows the positive relationship between organizational structure and healthcare waste management practices (HWMP). However, the findings of this study suggested that nurses and cleaners’ practices should critically consider structure dimensions such as formalization as well as moderating variables such as hospital location and type of services supplied on the interactions to improve the management of healthcare waste in Libya’s public hospitals.
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Raheem TY, Ojo O, Adenipekun EO, Olalekan AO, Oluwadun A, Iwalokun BA. Performance assessment of SD Bioline TB MPT64 assay for the diagnosis of Mycobacterium tuberculosis complex in Lagos, Nigeria. J Immunoassay Immunochem 2021; 42:543-558. [PMID: 33896359 DOI: 10.1080/15321819.2021.1911812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This study assessed the performance of SD Bioline MPT64 immunochromatographic test for the identification of Mycobacterium tuberculosis complex (MTBC) in Nigeria.A total of 157 mycobacterial isolates, comprising 120 (76.4%) MTBC (M. tuberculosis, 112; M. africanum, 5; M. bovis, 3) and 37 (23.6%) non-tuberculous mycobacteria (NTM) isolates from patients attending six DOTS centers in Lagos between June 2012 and July 2014 were analyzed. All the isolates were grown on Bactec MGIT960 liquid media and identified in parallel by the conventional method and MPT64 immunochromatographic test. Discrepant results were resolved using the line probe assay.The comorbid disease rates for HIV and type 2 diabetes were 20.9% and 8.2%, respectively. Compared to the conventional method, SD Bioline MPT64 identified 117 MTBC isolates correctly, producing a sensitivity of 97.5% (95% CI, 92.9-99.2) at a shorter growing median time of 11 days compared to 26 days by the conventional method. The three undetected MTBC were confirmed by the line probe assay to be M. tuberculosis strains. The test also identified all the NTM correctly producing a specificity of 100% (95% CI, 90.7-100).This study supports the integration of SD Bioline TB MPT64 antigen test into diagnostic workflow for rapid MTBC case identification in Nigeria.
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Affiliation(s)
- T Y Raheem
- Molecular Biology & Biotechnology Division, Nigerian Institute of Medical Research, Lagos, Nigeria.,Department of Medical Microbiology & Parasitology, Olabisi Onabanjo University, Sagamu-Ogun State, Nigeria
| | - O Ojo
- Department of Biological Sciences, Albany State University, Albany, Georgia, USA
| | - E O Adenipekun
- Department of Medical Laboratory Science, College of Medicine, University of Lagos, Lagos, Nigeria
| | - A O Olalekan
- Department of Medical Laboratory Science, College of Medicine, University of Lagos, Lagos, Nigeria
| | - A Oluwadun
- Department of Medical Microbiology & Parasitology, Olabisi Onabanjo University, Sagamu-Ogun State, Nigeria
| | - B A Iwalokun
- Molecular Biology & Biotechnology Division, Nigerian Institute of Medical Research, Lagos, Nigeria.,Department of Medical Microbiology & Parasitology, Olabisi Onabanjo University, Sagamu-Ogun State, Nigeria
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4
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Novel phage display-derived recombinant antibodies recognizing both MPT64 native and mutant (63-bp deletion) are promising tools for tuberculosis diagnosis. Biologicals 2021; 72:54-57. [PMID: 34247914 DOI: 10.1016/j.biologicals.2021.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/10/2021] [Accepted: 07/02/2021] [Indexed: 11/21/2022] Open
Abstract
Tuberculosis (TB) is one of the top 10 causes of death in humans worldwide. The most important causative agents of TB are bacteria from the Mycobacterium tuberculosis complex (MTC), although nontuberculous mycobacteria (NTM) can also cause similar infections. The ability to identify and differentiate MTC isolates from NTM is important for the selection of the correct antimicrobial therapy. Immunochromatographic assays with antibodies anti-MPT64 allow differentiation between MTC and NTM since the MPT64 protein is specific from MTC. However, studies reported false-negative results mainly due to mpt64 63-bp deletion. Considering this drawback, we selected seven human antibody fragments against MPT64 by phage display and produced them as scFv-Fc. Three antibodies reacted with rMPT64 mutant (63-bp deletion) protein and native MPT64 from M. tuberculosis H37Rv in ELISA and Western blot. These antibodies are new biological tools with the potential for the development of TB diagnosis helping to overcome limitations of the MPT64-based immunochromatographic tests currently available.
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5
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Cao XJ, Li YP, Wang JY, Zhou J, Guo XG. MPT64 assays for the rapid detection of Mycobacterium tuberculosis. BMC Infect Dis 2021; 21:336. [PMID: 33838648 PMCID: PMC8035777 DOI: 10.1186/s12879-021-06022-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 03/17/2021] [Indexed: 02/07/2023] Open
Abstract
Background Tuberculosis (TB) is a serious infectious disease caused by Mycobacterium tuberculosis (MTB). An estimated 1.7 billion people worldwide are infected with Mycobacterium tuberculosis (LTBI) during the incubation period without any obvious symptoms. Because of MTB’s high infection and mortality rates, there is an urgent need to develop a fast, portable, and sensitive diagnostic technology for its detection. Methods We included research from PubMed, Cochrane Library, Web of Science, and Embase and extracted the data. MetaDisc and STATA were used to build forest plots, Deek’s funnel plot, Fagan plot, and bivariate boxplot for analysis. Results Forty-six articles were analyzed, the results of which are as follows: sensitivity and specificity were 0.92 (0.91–0.93) and 0.95 (0.94–0.95) respectively. The NLR and PLR were 0.04 (95% CI 0.03–0.07) and 25.32 (95% CI 12.38–51.78) respectively. DOR was 639.60 (243.04–1683.18). The area under the SROC curve (AUC) was 0.99. Conclusions MPT64 exhibits good diagnostic efficiency for MTB. There is no obvious heterogeneity between the three commercial kits. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06022-w.
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Affiliation(s)
- Xun-Jie Cao
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Ya-Ping Li
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China.,Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Jia-Ying Wang
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Jie Zhou
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China
| | - Xu-Guang Guo
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China. .,Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, 511436, China. .,Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China. .,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.
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6
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Cunnama L, Gomez GB, Siapka M, Herzel B, Hill J, Kairu A, Levin C, Okello D, DeCormier Plosky W, Garcia Baena I, Sweeney S, Vassall A, Sinanovic E. A Systematic Review of Methodological Variation in Healthcare Provider Perspective Tuberculosis Costing Papers Conducted in Low- and Middle-Income Settings, Using An Intervention-Standardised Unit Cost Typology. PHARMACOECONOMICS 2020; 38:819-837. [PMID: 32363543 PMCID: PMC7437656 DOI: 10.1007/s40273-020-00910-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND There is a need for easily accessible tuberculosis unit cost data, as well as an understanding of the variability of methods used and reporting standards of that data. OBJECTIVE The aim of this systematic review was to descriptively review papers reporting tuberculosis unit costs from a healthcare provider perspective looking at methodological variation; to assess quality using a study quality rating system and machine learning to investigate the indicators of reporting quality; and to identify the data gaps to inform standardised tuberculosis unit cost collection and consistent principles for reporting going forward. METHODS We searched grey and published literature in five sources and eight databases, respectively, using search terms linked to cost, tuberculosis and tuberculosis health services including tuberculosis treatment and prevention. For inclusion, the papers needed to contain empirical unit cost estimates for tuberculosis interventions from low- and middle-income countries, with reference years between 1990 and 2018. A total of 21,691 papers were found and screened in a phased manner. Data were extracted from the eligible papers into a detailed Microsoft Excel tool, extensively cleaned and analysed with R software (R Project, Vienna, Austria) using the user interface of RStudio. A study quality rating was applied to the reviewed papers based on the inclusion or omission of a selection of variables and their relative importance. Following this, machine learning using a recursive partitioning method was utilised to construct a classification tree to assess the reporting quality. RESULTS This systematic review included 103 provider perspective papers with 627 unit costs (costs not presented here) for tuberculosis interventions among a total of 140 variables. The interventions covered were active, passive and intensified case finding; tuberculosis treatment; above-service costs; and tuberculosis prevention. Passive case finding is the detection of tuberculosis cases where individuals self-identify at health facilities; active case finding is detection of cases of those not in health facilities, such as through outreach; and intensified case finding is detection of cases in high-risk populations. There was heterogeneity in some of the reported methods used such cost allocation, amortisation and the use of top-down, bottom-up or mixed approaches to the costing. Uncertainty checking through sensitivity analysis was only reported on by half of the papers (54%), while purposive and convenience sampling was reported by 72% of papers. Machine learning indicated that reporting on 'Intervention' (in particular), 'Urbanicity' and 'Site Sampling', were the most likely indicators of quality of reporting. The largest data gap identified was for tuberculosis vaccination cost data, the Bacillus Calmette-Guérin (BCG) vaccine in particular. There is a gap in available unit costs for 12 of 30 high tuberculosis burden countries, as well as for the interventions of above-service costs, tuberculosis prevention, and active and intensified case finding. CONCLUSION Variability in the methods and reporting used makes comparison difficult and makes it hard for decision makers to know which unit costs they can trust. The study quality rating system used in this review as well as the classification tree enable focus on specific reporting aspects that should improve variability and increase confidence in unit costs. Researchers should endeavour to be explicit and transparent in how they cost interventions following the principles as laid out in the Global Health Cost Consortium's Reference Case for Estimating the Costs of Global Health Services and Interventions, which in turn will lead to repeatability, comparability and enhanced learning from others.
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Affiliation(s)
- Lucy Cunnama
- Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Cape Town, South Africa.
| | - Gabriela B Gomez
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Mariana Siapka
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Ben Herzel
- Institute for Health Policy Studies, University of California, San Francisco, CA, USA
| | - Jeremy Hill
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Angela Kairu
- Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Cape Town, South Africa
| | - Carol Levin
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Dickson Okello
- Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Cape Town, South Africa
| | | | - Inés Garcia Baena
- TB Monitoring and Evaluation (TME), Global TB Programme, The World Health Organization, Geneva, Switzerland
| | - Sedona Sweeney
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Anna Vassall
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Edina Sinanovic
- Health Economics Unit, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Cape Town, South Africa
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Singh K, Kumari R, Tripathi R, Gupta A, Anupurba S. Mutation in MPT64 gene influencing diagnostic accuracy of SD Bioline assay (capilia). BMC Infect Dis 2019; 19:1048. [PMID: 31829183 PMCID: PMC6907232 DOI: 10.1186/s12879-019-4671-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 11/29/2019] [Indexed: 12/04/2022] Open
Abstract
Background Success of India’s TB control program relies on rapid case detection, monitoring, care and treatment of drug resistance. Patients on multidrug resistance (MDR) treatment are monitored by follow up cultures. Discordant results (culture and smear positive while capilia negative) are usually declared negative Mycobacterium tuberculosis complex (MTBC). This study was designed to understand the possible causes of discordant results. Methods The capilia kit was evaluated to test its utility among 4737 follow up MDR patients enrolled during a period of 1 year. A total of 889 were liquid culture positive, 3375 were negative and 473 were contaminated. Of the 889 cultures positive, 829 were found positive by ZN smear, capilia test and MTBDR plus assay. The cultures which gave a positive result on Mycobacterium Growth Indicator Tube 960 (MGIT 960) and ZN smear but were negative on capilia test with no growth on Brain Heart Infusion agar (BHI) were included in this study. The conflicting results of capilia were compared with other molecular techniques; MTBDR plus assay and DNA sequence analysis of MPT64 gene. Results Out of 889 culture positive, 60 (6.7%) were found positive on liquid culture and ZN smear but were negative on capilia. Of these 60 cultures, 10 (16.7%) were found positive by both MTBDR plus assay and PCR. The sequencing analysis revealed that all of the capilia negative isolates had mutations within the MPT64 gene. Conclusion Re-evaluation of culture positive but capilia negative isolates should be done before declaring them as Mycobacterium other than tuberculosis (MOTT) because such cases can act as chronic carriers of TB in the population which can lead to the rise of this lethal disease.
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Affiliation(s)
- Kamal Singh
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Richa Kumari
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Rajneesh Tripathi
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ankush Gupta
- Department of Biochemistry, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Shampa Anupurba
- Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
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Phetsuksiri B, Rudeeaneksin J, Srisungngam S, Bunchoo S, Klayut W, Sangkitporn S, Nakajima C, Hamada S, Suzuki Y. Loop-Mediated Isothermal Amplification for Rapid Identification of Mycobacterium tuberculosis in Comparison with Immunochromatographic SD Bioline MPT64 Rapid ® in a High Burden Setting. Jpn J Infect Dis 2018; 72:112-114. [PMID: 30381677 DOI: 10.7883/yoken.jjid.2018.128] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Loop-mediated isothermal amplification (LAMP) was assessed for rapid identification of Mycobacterium tuberculosis complex (MTC) in comparison with an immunochromatographic test (ICT) using SD Bioline Ag MPT64 Rapid®. One hundred and fifty-one MGIT cultures positive for acid-fast bacilli were tested for MTC. DNA was extracted from a small portion of culture samples by heat lysis and subjected to LAMP analysis. Of these, 144 were positive and 5 were negative by both tests. One culture that was ICT negative but was LAMP positive was confirmed to have a mutation in the mpt64 gene. The agreement was 98.68% (95% confidence interval [CI]: 94.80-99.77), and the kappa value was 0.83% (95% CI: 0.59-1.00). Good correlation results suggested that LAMP assay is a reliable molecular test for rapid identification of MTC and is practical for use in resource-limited, high burden settings.
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Affiliation(s)
- Benjawan Phetsuksiri
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health
| | - Janisara Rudeeaneksin
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health
| | - Sopa Srisungngam
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health
| | - Supranee Bunchoo
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health
| | - Wiphat Klayut
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health
| | - Somchai Sangkitporn
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health
| | - Chie Nakajima
- Division of Global Epidemiology, Hokkaido University Research Center for Zoonosis Control.,Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University
| | - Shigeyuki Hamada
- Section of Bacterial Infections, Research Collaboration Center for Emerging and Re-emerging Infectious Diseases.,Research Institute for Microbial Diseases, Osaka University
| | - Yasuhiko Suzuki
- Division of Global Epidemiology, Hokkaido University Research Center for Zoonosis Control.,Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University
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Naidoo N, Pillay M. Bacterial pili, with emphasis on Mycobacterium tuberculosis curli pili: potential biomarkers for point-of care tests and therapeutics. Biomarkers 2016; 22:93-105. [PMID: 27797276 DOI: 10.1080/1354750x.2016.1252960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
CONTEXT Novel biomarkers are essential for developing rapid diagnostics and therapeutic interventions Objective: This review aimed to highlight biomarker characterisation and assessment of unique bacterial pili. METHODS A PubMed search for bacterial pili, diagnostics, vaccine and therapeutics was performed, with emphasis on the well characterised pili. RESULTS In total, 46 papers were identified and reviewed. CONCLUSION Extensive analyses of pili enabled by advanced nanotechnology and whole genome sequencing provide evidence that they are strong biomarker candidates. Mycobacterium tuberculosis curli pili are emphasised as important epitopes for the development of much needed point-of-care diagnostics and therapeutics.
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Affiliation(s)
- Natasha Naidoo
- a Medical Microbiology and Infection Control , School of Laboratory Medicine and Medical Sciences, College of Health Science, University of KwaZulu-Natal, Congella , Durban , South Africa
| | - Manormoney Pillay
- a Medical Microbiology and Infection Control , School of Laboratory Medicine and Medical Sciences, College of Health Science, University of KwaZulu-Natal, Congella , Durban , South Africa
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10
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Rapid identification of Mycobacterium tuberculosis complex in clinical isolates by combining presumptive cord formation and MPT64 Antigen Immunochromatographic Assay. Indian J Tuberc 2015; 62:86-90. [PMID: 26117477 DOI: 10.1016/j.ijtb.2015.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 04/07/2015] [Indexed: 11/22/2022]
Abstract
PURPOSE Combining the results of presumptive cord formation in smear and MPT64 Antigen Immunochromatographic Assay has been suggested to reduce the false negative and positive rates for identification of Mycobacterium tuberculosis (MTB) complex in liquid culture. This study was done to evaluate the clinical utility of combining the results of the two tests for rapid identification MTB complex in mycobacterial isolates. METHODS 484 isolates of mycobacteria obtained in MGIT culture were identified using presumptive cord formation in smear and further by MPT64 Antigen ICT assay. Result obtained were analyzed taking PNB inhibition test as the reference standard. RESULTS Combining the results of the two tests, 464 (95.9%) isolates were correctly identified while discrepant results were obtained in 20 (4.1%) isolates. When the results of the two tests were intersected, the specificity and PPV was 100%, but the sensitivity decreased to 96.4% and the NPV to 68.6%. On the other hand, when the results of the two methods were combined, the sensitivity and NPV was 100%, but the specificity decreased to 88.6% and the PPV to 99.1%. CONCLUSION Presumptive cord formation and MPT64 antigen ICT assay can be used in combination for identification of MTB complex. When both the test are positive, the culture can be reported to contain MTB complex. If both the tests are negative, the culture should be reported to contain NTM. Only when discrepant results are obtained by the two tests, further evaluation is necessary to ensure an accurate diagnosis.
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11
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MPT64 polymorphisms of Mycobacterium tuberculosis strains suggest ongoing immune evasion. Tuberculosis (Edinb) 2014; 94:712-4. [PMID: 25266921 DOI: 10.1016/j.tube.2014.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 08/22/2014] [Indexed: 11/21/2022]
Abstract
In our previous study, we found that polymorphisms of the mpt64 gene in the Mycobacterium tuberculosis complex (MTBC) may be the reason for changes in the antigen produced, which may in turn cause alterations of related functions. Based on the data, we further analyzed T/B cell epitope regions and non-epitope regions and compared amino acid changes between them. It turned out the polymorphisms of MPT64 affected both T cell epitopes and B cell epitopes, which thus influenced cell-mediated immunity and humoral immunity at the same time. Both T cell epitope regions and B cell epitope regions had higher dN/dS values than corresponding non-epitope regions, which means the formers have accumulated significantly more amino acid changes than the latters.
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12
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Fuchs M, Kämpfer S, Helmsing S, Spallek R, Oehlmann W, Prilop W, Frank R, Dübel S, Singh M, Hust M. Novel human recombinant antibodies against Mycobacterium tuberculosis antigen 85B. BMC Biotechnol 2014; 14:68. [PMID: 25033887 PMCID: PMC4119940 DOI: 10.1186/1472-6750-14-68] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 07/01/2014] [Indexed: 11/10/2022] Open
Abstract
Background Tuberculosis is the leading cause of death due to bacterial infections worldwide, mainly caused by Mycobacterium tuberculosis. The antigen 85 complex comprises a set of major secreted proteins of M. tuberculosis, which are potential biomarkers for diagnostic. Results In this work, the first human single chain fragment variable (scFv) antibodies specific for the tuberculosis biomarker 85 B were selected by phage display from naïve antibody gene libraries (HAL7/8). Produced as scFv-Fc in mammalian cells, these antibodies were further characterized and analysed for specificity and applicability in different tuberculosis antigen detection assays. Sandwich detection of recombinant 85 B was successful in enzyme linked immunosorbent assay (ELISA), lateral flow immunoassay and immunoblot. Whereas detection of M. tuberculosis cell extracts and culture filtrates was only possible in direct ELISA and immunoblot assays. It was found that the conformation of 85 B, depending on sample treatment, influenced antigen detection. Conclusions Recombinant antibodies, selected by phage display, may be applicable for 85 B detection in various assays. These antibodies are candidates for the development of future point of care tuberculosis diagnostic kits. Using 85 B as a biomarker, the antigen conformation influenced by sample treatment is important.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Michael Hust
- Technische Universität Braunschweig, Institut für Biochemie und Biotechnologie, Spielmannstr,7, 38106 Braunschweig, Germany.
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13
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Naidoo N, Ramsugit S, Pillay M. Mycobacterium tuberculosis pili (MTP), a putative biomarker for a tuberculosis diagnostic test. Tuberculosis (Edinb) 2014; 94:338-45. [PMID: 24721207 PMCID: PMC7185575 DOI: 10.1016/j.tube.2014.03.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 03/08/2014] [Accepted: 03/10/2014] [Indexed: 11/30/2022]
Abstract
Novel biomarkers are urgently needed for point of care TB diagnostics. In this study, we investigated the potential of the pilin subunit protein encoded by the mtp gene as a diagnostic biomarker. BLAST analysis of the mtp gene on published genome databases, and amplicon sequencing were performed in Mycobacterium tuberculosis Complex (MTBC) strains and other organisms. The protein secondary structure of the amino acid sequences of non-tuberculous Mycobacteria that partially aligned with the mtp sequence was analysed with PredictProtein software. The mtp gene and corresponding amino acid sequence of MTBC were 100% homologous with H37Rv, in contrast to the partial alignment of the non-tuberculous Mycobacteria. The mtp gene was present in all 91 clinical isolates of MTBC. Except for 2 strains with point mutations, the sequence was 100% conserved among the clinical strains. The mtp gene could not be amplified in all non-tuberculous Mycobacteria and respiratory organisms. The predicted MTP protein structure of Mycobacterium avium, Mycobacterium ulcerans and Mycobacterium abscessus differed significantly from that of the M. tuberculosis, which was similar to Mycobacterium marinum. The absence of the mtp gene in non-tuberculous Mycobacteria and other respiratory bacteria suggests that its encoded product, the pilin subunit protein of M. tuberculosis may be a suitable marker for a point of care TB test.
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Affiliation(s)
- Natasha Naidoo
- Medical Microbiology and Infection Control, School of Laboratory Medicine and Medical Sciences, College of Health Science, University of KwaZulu-Natal, South Africa.
| | - Saiyur Ramsugit
- Medical Microbiology and Infection Control, School of Laboratory Medicine and Medical Sciences, College of Health Science, University of KwaZulu-Natal, South Africa.
| | - Manormoney Pillay
- Medical Microbiology and Infection Control, School of Laboratory Medicine and Medical Sciences, College of Health Science, University of KwaZulu-Natal, South Africa.
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Assessment of the BD MGIT TBc identification test for the detection of Mycobacterium tuberculosis complex in a network of mycobacteriology laboratories. BIOMED RESEARCH INTERNATIONAL 2014; 2014:398108. [PMID: 24587985 PMCID: PMC3920968 DOI: 10.1155/2014/398108] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 11/18/2013] [Indexed: 11/23/2022]
Abstract
We evaluate the performance of the TBcID assay in a panel of 100 acid-fast bacilli cultures. Sixty-four isolates were TBcID positive for Mycobacterium tuberculosis complex (MTBC), whereas 36 gave negative results. These included 28 nontuberculous mycobacteria, one nonmycobacterial isolate, one M. tuberculosis, and six M. bovis BCG strains. This corresponds to a sensitivity of 90.14%, specificity of 100%, and positive and negative predictive values of 100% and 80.55%, respectively. The test is rapid, easy to perform and interpret, and does not require sample preparation or instrumentation. However, a negative result does not exclude the presence of a strain belonging to MTBC, especially when mutations in mpb64 gene are present or some M. bovis BCG strains are isolated. The TBcID showed potential to assist in the identification of MTBC when the implementation and usage of molecular methods are often not possible, principally in resource-limited countries.
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Yin X, Zheng L, Lin L, Hu Y, Zheng F, Hu Y, Wang Q. Commercial MPT64-based tests for rapid identification of Mycobacterium tuberculosis complex: A meta-analysis. J Infect 2013; 67:369-77. [DOI: 10.1016/j.jinf.2013.06.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 06/04/2013] [Accepted: 06/15/2013] [Indexed: 11/26/2022]
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16
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Sensitivity, specificity, and reproducibility of the Capilia TB-Neo assay. J Clin Microbiol 2013; 51:4237-9. [PMID: 24108604 DOI: 10.1128/jcm.02441-13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The performance of the Capilia TB-Neo assay, a new-generation assay, was assessed by determining its sensitivity, specificity, reproducibility, and cross-reaction with contaminating organisms. The sensitivity and specificity were 99.2 and 96.4% and 89.3 and 100% in pure and mixed-culture isolates, respectively. The kappa statistic was 95.0 and 77.9% in pure and mixed culture isolates, respectively. There was no cross-reaction with contaminating organisms.
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Anuwatnonthakate A, Whitehead SJ, Varma JK, Silachamroon U, Kasetjaroen Y, Moolphate S, Limsomboon P, Inyaphong J, Suriyon N, Kavinum S, Chiengson N, Tunteerapat P, Kaewkungwal J. Effect of mycobacterial drug resistance patterns on patients' survival: a cohort study in Thailand. Glob J Health Sci 2013; 5:60-72. [PMID: 24171875 PMCID: PMC4776856 DOI: 10.5539/gjhs.v5n6p60] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 08/12/2013] [Indexed: 11/12/2022] Open
Abstract
Background: Drug resistance substantially increases tuberculosis (TB) mortality. This study aimed to describe the prevalence of mycobacterial drug resistance pattern and association of common resistance patterns with TB mortality in Thailand. Method: A retrospective cohort study was conducted using TB surveillance data. A total of 9,518 culture-confirmed, pulmonary TB patients registered from 1 October 2004 to 31 December 2008 from the Thailand TB Active Surveillance Network were included in this study. Patients were followed up until TB treatment completion or death. Mycobacterial drug resistance patterns were categorized as pan-susceptible, rifampicin resistance, isoniazid monoresistance, and ethambutol/streptomycin resistance. Drug susceptibility testing (DST) was determined by Mycobacterial Growth Indicator Tube (MGIT) liquid culture systems. Survival analysis was applied. Result: Isoniazid monoresistance was the most common pattern, while rifampicin resistance had the largest impact on mortality. Cox regression analysis showed a significantly higher risk of death among patients with rifampicin resistance (adjusted hazard ratio (aHR) 1.9, 95% confident interval (CI), 1.5-2.5) and isoniazid monoresistance (aHR 1.4, 95% CI 1.1-1.7) than those with pan-susceptible group after adjustment for age, nationality, human immunodeficiency virus (HIV) and antiretroviral therapy (ART) status, diabetes mellitus, cavitary disease on chest x-ray, treatment observation, and province. HIV co-infection was associated with higher mortality in patients both on ART (aHR 1.9, 95% CI 1.5-2.5) and not on ART (aHR 8.1, 95% CI 6.8-9.8). Conclusion: Rifampicin resistance and isoniazid monoresistance were associated with increased TB mortality. HIV-coinfection was associated with a higher risk of death including among those taking antiretroviral therapy.
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Yin X, Zheng L, Wu L, Cao N, Zheng F, Hu Y, Lin M, Zhang P, Wang Q. Comparative evaluation of two rapid methods for differentiating mycobacteria. Tuberculosis (Edinb) 2013; 93:227-31. [PMID: 23414675 DOI: 10.1016/j.tube.2013.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 01/08/2013] [Accepted: 01/10/2013] [Indexed: 10/27/2022]
Abstract
The real-time PCR with duplex primer sets and the MPB64-based immunochromatographic assay are newly developed methods for rapid differentiation of mycobacteria. The aim of this study is to evaluate the two methods for differentiation between Mycobacterium tuberculosis complex and nontuberculous mycobacteria. A total of 95 clinical mycobacterial isolates belonging to 22 different species and 16 reference strains of 16 different species were differentiated by duplex real-time PCR method and MPB64-based immunochromatographic assay method. The two methods were evaluated by comparison with conventional biochemical technique as the gold standard method. The duplex real-time PCR method correctly differentiated all reference strains as well as the MPB64-based immunochromatographic assay method. For clinical isolates, the accuracy of the duplex real-time PCR method (100%) was slightly higher than the MPB64-based immunochromatographic assay method (97.9%), but there was no statistical significance between the two methods (P > 0.05), and there was an excellent agreement between them (Kappa = 0.957). The duplex real-time PCR method possesses greater potential for differentiation of mycobacteria in the clinical laboratory than the MPB64-based immunochromatographic assay method. However, the MPB64-based immunochromatographic assay method is more convenient than the duplex real-time PCR method when the number of sample is small.
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Affiliation(s)
- Xiaomao Yin
- Laboratory Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province 510515, PR China
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Zhang Y, Sun K, Yu L, Tang Z, Huang S, Meng Z, Zheng Y, Wen Y, Zhu H, Chen RY, Varma JK, Zhang F. Factors associated with survival among adults with HIV-associated TB in Guangxi, China: a retrospective cohort study. Future Virol 2012. [DOI: 10.2217/fvl.12.76] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: Although China has the second highest burden of TB in the world and faces a burgeoning HIV epidemic, the epidemiology and 12-month clinical outcomes of HIV-infected TB patients have not previously been reported. Methods: We reviewed records of all HIV-infected adults diagnosed with culture-confirmed TB from four HIV clinics in Guangxi, China from August 2006 to December 2008. Factors associated with patients’ survival within 12 months after TB diagnosis were evaluated in Cox proportional hazards models. Results: Among the 201 patients included, 47 (23%) died within 12 months. Median CD4 count at TB diagnosis was 37 cells/mm3 (interquartile range: 16–102). Receiving HAART (adjusted hazard ratio [AHR]: 4.2; 95% CI: 1.6–10.8), receiving TB treatment (AHR: 9.0; 95% CI: 1.5–53.5) and baseline BMI ≥ 18.5 (AHR: 8.4; 95% CI: 1.9–35.8) were independently associated with survival. Among 171 (85%) patients who received TB treatment, receiving HAART (HR: 5.1; 95% CI: 2.4–10.7) was the only factor significantly associated with survival. Conclusion: HIV-infected Chinese patients diagnosed with TB in Guangxi are at high risk of death within 12 months, a risk that is strongly mitigated by antiretroviral therapy. Improving survival from HIV-associated TB in China will require the integration of TB and HIV programs to improve access to treatment for both diseases.
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Affiliation(s)
- Yao Zhang
- National Center for AIDS/STD Control & Prevention, Chinese Center for Disease Control & Prevention, Beijing, China
| | - Kai Sun
- University of North Carolina, Chapel Hill, NC, USA
| | - Lan Yu
- National Center for AIDS/STD Control & Prevention, Chinese Center for Disease Control & Prevention, Beijing, China
| | - Zhirong Tang
- Provincial Center for Diseases Control & Prevention of Guangxi, Nanning, China
| | | | | | - Yuanjia Zheng
- Center for Disease Control & Prevention of Liuzhou City, Liuzhou, China
| | - Yi Wen
- National Center for AIDS/STD Control & Prevention, Chinese Center for Disease Control & Prevention, Beijing, China
| | - Hao Zhu
- University of North Carolina, Chapel Hill, NC, USA
| | - Ray Y Chen
- The National Institute of Allergy & Infectious Diseases, US National Institutes of Health, Bethesda, MD, USA
| | - Jay K Varma
- United States Centers for Disease Control & Prevention, Atlanta, GA, USA
| | - Fujie Zhang
- Capital Medical University, Beijing Ditan Hospital, Beijing, China
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van Kampen SC, Oskam L, Tuijn CJ, Klatser PR. Survey of the diagnostic retooling process in national TB reference laboratories, with special focus on rapid speciation tests endorsed by WHO in 2007. PLoS One 2012; 7:e43439. [PMID: 22937050 PMCID: PMC3427371 DOI: 10.1371/journal.pone.0043439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 07/23/2012] [Indexed: 12/02/2022] Open
Abstract
Background Successful integration of new diagnostics in national tuberculosis (TB) control programs, also called ‘retooling’, is highly dependent on operational aspects related to test availability, accessibility and affordability. This survey aimed to find out whether recommendations to use new diagnostics lead to successful retooling in high TB endemic countries, using immunochromatographic tests (ICTs) for TB culture speciation as a case study. ICTs are recommended to accurately confirm the presence of bacteria of the Mycobacterium tuberculosis complex in liquid culture isolates. Methods and Findings Questionnaires were sent to national TB reference laboratories (NRLs) in 42 high TB endemic countries to address their access to information on ICT implementation, logistics related to availability, accessibility and affordability of ICTs, and testing algorithms. Results from 16 responding countries indicated that half of the NRLs were aware of the contents of WHO guidance documents on liquid culture and ICT implementation, as well as their eligibility for a negotiated pricing agreement for ICT procurement. No major issues with availability and accessibility of ICTs were raised. When asked about testing algorithms, ICTs were not used as stand-alone or first test for TB culture identification as recommended by WHO. Conclusions The low response rate was a limitation of this survey and together with NRLs managers' unawareness of global guidance, suggests a lack of effective communication between partners of the global laboratory network and NRLs. TB tests could become more affordable to high TB endemic countries, if the possibility to negotiate lower prices for commercial products is communicated to them more successfully. NRLs need additional guidance to identify where available technologies can be most usefully implemented and in what order, taking into account long-term laboratory strategies.
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Affiliation(s)
- Sanne C van Kampen
- Royal Tropical Institute, Royal Tropical Institute Biomedical Research, Amsterdam, The Netherlands.
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Považan A, Vukelić A, Savković T, Kurucin T. Use of immunochromatographic assay for rapid identification of Mycobacterium tuberculosis complex from liquid culture. Bosn J Basic Med Sci 2012; 12:33-6. [PMID: 22364301 DOI: 10.17305/bjbms.2012.2531] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A new, simple immunochromatographic assay for rapid identification of Mycobacterium tuberculosis complex in liquid cultures has been developed. The principle of the assay is binding of the Mycobacterium tuberculosis complex specific antigen to the monoclonal antibody conjugated on the test strip. The aim of this study is evaluation of the performance of immunochromatographic assay in identification of Mycobacterium tuberculosis complex in primary positive liquid cultures of BacT/Alert automated system. A total of 159 primary positive liquid cultures were tested using the immunochromatographic assay (BD MGIT TBc ID) and the conventional subculture, followed by identification using biochemical tests.Of 159 positive liquid cultures, using the conventional method, Mycobacterium tuberculosis was identified in 119 (74.8%), nontuberculous mycobacteria were found in 4 (2.5%), 14 (8.8%) cultures were contaminated and 22 (13.8%) cultures were found to be negative. Using the immunochromatographic assay, Mycobacterium tuberculosis complex was detected in 118 (74.2%) liquid cultures, and 41 (25.8%) tests were negative. Sensitivity, specificity, positive and negative predictive values of the test were 98.3%; 97.5%; 99.15% i 95.12%, respectively. The value of kappa test was 0.950, and McNemar test was 1.00. The immunochromatographic assay is a simple and rapid test which represents a suitable alternative to the conventional subculture method for the primary identification of Mycobacterium tuberculosis complex in liquid cultures of BacT/Alert automated system.
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Affiliation(s)
- Anika Považan
- Institute for Pulmonary Diseases of Vojvodina, Center for Microbiology, Immunology and Virusology, Sremska Kamenica, Serbia.
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McCarthy KD, Cain KP, Winthrop KL, Udomsantisuk N, Lan NTN, Sar B, Kimerling ME, Kanara N, Lynen L, Monkongdee P, Tasaneeyapan T, Varma JK. Nontuberculous Mycobacterial Disease in Patients with HIV in Southeast Asia. Am J Respir Crit Care Med 2012; 185:981-8. [DOI: 10.1164/rccm.201107-1327oc] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Muchwa C, Akol J, Etwom A, Morgan K, Orikiriza P, Mumbowa F, Odong PR, Kateete DP, Eisenach KD, Joloba ML. Evaluation of Capilia TB assay for rapid identification of Mycobacterium tuberculosis complex in BACTEC MGIT 960 and BACTEC 9120 blood cultures. BMC Res Notes 2012; 5:44. [PMID: 22260090 PMCID: PMC3282630 DOI: 10.1186/1756-0500-5-44] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 01/19/2012] [Indexed: 11/16/2022] Open
Abstract
Background Capilia TB is a simple immunochromatographic assay based on the detection of MPB64 antigen specifically secreted by the Mycobacterium tuberculosis complex (MTC). Capilia TB was evaluated for rapid identification of MTC from BACTEC MGIT 960 and BACTEC 9120 systems in Kampala, Uganda. Since most studies have mainly dealt with respiratory samples, the performance of Capilia TB on blood culture samples was also evaluated. Methods One thousand samples from pulmonary and disseminated tuberculosis (TB) suspects admitted to the JCRC clinic and the TB wards at Old Mulago hospital in Kampala, Uganda, were cultured in automated BACTEC MGIT 960 and BACTEC 9120 blood culture systems. BACTEC-positive samples were screened for purity by sub-culturing on blood agar plates. Two hundred and fifty three (253) samples with Acid fast bacilli (AFB, 174 BACTEC MGIT 960 and 79 BACTEC 9120 blood cultures) were analyzed for presence of MTC using Capilia TB and in-house PCR assays. Results The overall Sensitivity, Specificity, Positive and Negative Predictive values, and Kappa statistic for Capilia TB assay for identification of MTC were 98.4%, 97.6%, 97.7%, 98.4% and 0.96, respectively. Initially, the performance of in-house PCR on BACTEC 9120 blood cultures was poor (Sensitivity, Specificity, PPV, NPV and Kappa statistic of 100%, 29.3%,7%, 100% and 0.04, respectively) but improved upon sub-culturing on solid medium (Middlebrook 7H10) to 100%, 95.6%, 98.2%, 100% and 0.98, respectively. In contrast, the Sensitivity and Specificity of Capilia TB assay was 98.4% and 97.9%, respectively, both with BACTEC blood cultures and Middlebrook 7H10 cultured samples, revealing that Capilia was better than in-house PCR for identification of MTC in blood cultures. Additionally, Capilia TB was cheaper than in-house PCR for individual samples ($2.03 vs. $12.59, respectively), and was easier to perform with a shorter turnaround time (20 min vs. 480 min, respectively). Conclusion Capilia TB assay is faster and cheaper than in-house PCR for rapid identification of MTC from BACTEC MGIT 960 and BACTEC 9120 culture systems in real-time testing of AFB positive cultures.
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Affiliation(s)
- Christopher Muchwa
- Department of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
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Worodria W, Anderson J, Cattamanchi A, Davis JL, den Boon S, Andama A, Yoo SD, Joloba M, Huang L, Kato-Maeda M. The role of speciation in positive Lowenstein-Jensen culture isolates from a high tuberculosis burden country. PLoS One 2011; 6:e27017. [PMID: 22073241 PMCID: PMC3208568 DOI: 10.1371/journal.pone.0027017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 10/07/2011] [Indexed: 12/02/2022] Open
Abstract
Objective To determine the need for routine speciation of positive Lowenstein-Jensen mycobacterial cultures in HIV-infected patients suspected of having pulmonary tuberculosis at Mulago Hospital in Kampala, Uganda. Methods Sputum and bronchoalveolar lavage Lowenstein-Jensen mycobacterial culture isolates from consecutive, HIV-infected patients admitted to Mulago Hospital with 2 weeks or more of cough were subjected to IS6110 PCR and rpoB genetic analysis to determine the presence of Mycobacterium tuberculosis complex (MTBC) and non-tuberculous mycobacteria (NTM). Results Eighty (100%) mycobacterial cultures from 65 patients were confirmed to be members of MTBC. Subsequent analysis of the cultures from 54 patients by PCR and sequence analyses to identify co-infection with NTM confirmed the presence of MTBC as well as the presence of Micrococcus luteus (n = 4), Janibacter spp. (n = 1) and six cultures had organisms that could not be identified. Conclusions Presumptive diagnosis of tuberculosis on the basis of a positive Lowenstein-Jensen culture is sufficient in HIV-infected Ugandans suspected of having tuberculosis. Routine molecular confirmation of positive Lowenstein-Jensen cultures is unnecessary in this low resource setting.
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Affiliation(s)
- William Worodria
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Medicine, Mulago National Referral and Teaching Hospital, Kampala, Uganda
- San Francisco Research Collaboration, Makerere University-University of California San Francisco, Kampala, Uganda
- * E-mail:
| | - Jillian Anderson
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco General Hospital, San Francisco, California, United States of America
| | - Adithya Cattamanchi
- San Francisco Research Collaboration, Makerere University-University of California San Francisco, Kampala, Uganda
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco General Hospital, San Francisco, California, United States of America
- Curry International Tuberculosis Center, Department of Medicine, University of California San Francisco, San Francisco General Hospital, San Francisco, California, United States of America
| | - J. Lucian Davis
- San Francisco Research Collaboration, Makerere University-University of California San Francisco, Kampala, Uganda
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco General Hospital, San Francisco, California, United States of America
- Curry International Tuberculosis Center, Department of Medicine, University of California San Francisco, San Francisco General Hospital, San Francisco, California, United States of America
| | - Saskia den Boon
- San Francisco Research Collaboration, Makerere University-University of California San Francisco, Kampala, Uganda
| | - Alfred Andama
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Medicine, Mulago National Referral and Teaching Hospital, Kampala, Uganda
- San Francisco Research Collaboration, Makerere University-University of California San Francisco, Kampala, Uganda
| | - Samuel D. Yoo
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
- Department of Medicine, Mulago National Referral and Teaching Hospital, Kampala, Uganda
- San Francisco Research Collaboration, Makerere University-University of California San Francisco, Kampala, Uganda
| | - Moses Joloba
- Department of Microbiology, Makerere University School of Biomedical Sciences, Kampala, Uganda
| | - Laurence Huang
- San Francisco Research Collaboration, Makerere University-University of California San Francisco, Kampala, Uganda
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco General Hospital, San Francisco, California, United States of America
- Curry International Tuberculosis Center, Department of Medicine, University of California San Francisco, San Francisco General Hospital, San Francisco, California, United States of America
- HIV/AIDS Division, Department of Medicine, University of California San Francisco, San Francisco General Hospital, San Francisco, California, United States of America
| | - Midori Kato-Maeda
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California San Francisco, San Francisco General Hospital, San Francisco, California, United States of America
- Curry International Tuberculosis Center, Department of Medicine, University of California San Francisco, San Francisco General Hospital, San Francisco, California, United States of America
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Performance of the MGIT TBc identification test and meta-analysis of MPT64 assays for identification of the Mycobacterium tuberculosis complex in liquid culture. J Clin Microbiol 2011; 49:4343-6. [PMID: 21998426 DOI: 10.1128/jcm.05995-11] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Rapid MPT64-based immunochromatographic tests (MPT64 ICTs) have been developed to detect Mycobacterium tuberculosis complex (MTBC) in culture. We demonstrated the noninferiority of one commercial MTP64 ICT, the MGIT TBc identification (TBcID) test, to GenoType line probe assays for MTBC identification in positive MGIT cultures. Meta-analysis of MPT64 ICT performance for identification of MTBC in liquid culture confirmed similar very high sensitivities and specificities for all three commercial MPT64 assays for which sufficient data were available.
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Laboratory diagnosis of tuberculosis in resource-poor countries: challenges and opportunities. Clin Microbiol Rev 2011; 24:314-50. [PMID: 21482728 DOI: 10.1128/cmr.00059-10] [Citation(s) in RCA: 298] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
With an estimated 9.4 million new cases globally, tuberculosis (TB) continues to be a major public health concern. Eighty percent of all cases worldwide occur in 22 high-burden, mainly resource-poor settings. This devastating impact of tuberculosis on vulnerable populations is also driven by its deadly synergy with HIV. Therefore, building capacity and enhancing universal access to rapid and accurate laboratory diagnostics are necessary to control TB and HIV-TB coinfections in resource-limited countries. The present review describes several new and established methods as well as the issues and challenges associated with implementing quality tuberculosis laboratory services in such countries. Recently, the WHO has endorsed some of these novel methods, and they have been made available at discounted prices for procurement by the public health sector of high-burden countries. In addition, international and national laboratory partners and donors are currently evaluating other new diagnostics that will allow further and more rapid testing in point-of-care settings. While some techniques are simple, others have complex requirements, and therefore, it is important to carefully determine how to link these new tests and incorporate them within a country's national diagnostic algorithm. Finally, the successful implementation of these methods is dependent on key partnerships in the international laboratory community and ensuring that adequate quality assurance programs are inherent in each country's laboratory network.
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Evaluation of the Bactec MGIT 960 system in combination with the MGIT TBc identification test for detection of Mycobacterium tuberculosis complex in respiratory specimens. J Clin Microbiol 2011; 49:2290-2. [PMID: 21450949 DOI: 10.1128/jcm.00571-11] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The sensitivity and specificity of the MGIT TBc identification (TBc ID) test for Mycobacterium tuberculosis complex (MTC) detection in positive Bactec MGIT cultures were 95.2% and 99.2%, respectively. When MTC-positive results obtained from two additional molecular methods were included, the sensitivity of the MGIT TBc ID test was 85.4%, while that of culture was 95.7%.
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Kumar VG, Urs TA, Ranganath RR. MPT 64 Antigen detection for Rapid confirmation of M.tuberculosis isolates. BMC Res Notes 2011; 4:79. [PMID: 21429231 PMCID: PMC3074510 DOI: 10.1186/1756-0500-4-79] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Accepted: 03/24/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A new rapid Immunochromatographic test kit(SD MPT64TB Ag Kit) for detection of MPT 64 Antigen in M. tuberculosis isolates using mouse monoclonal MPT 64 Antibody developed by SD Bioline, South Korea was evaluated for rapid identification of M. tuberculosis isolates. We also assessed the sensitivity, specificity and predictive values of this kit. The test kit has an excellent sensitivity, specificity, negative predictive value & positive predictive value. This rapid method is found to be a reliable, rapid and cheaper method for confirming MTB culture isolates in resource poor laboratories. MATERIAL/METHODS 54 culture isolates of M. tuberculosis in broth & on LJ medium, 12 Non mycobacterial isolates, 10 Non tubercular (NTM) rapidly growing Mycobacteria isolated from pus & 5 smear positive sputum samples were tested for detection of MPT64 antigen using the SD Bioline immunochromatography (ICT)test kit. H37 RV strain was employed as the positive reference control. FINDINGS H37 RV strain showed the presence of MPT64 antigen band. Similar band was formed in all the 54 MTB isolates tested proving 100% sensitivity. MPT64 band formation was not detected in any of the other test isolates which proved the 100% specificity of the test kit. Both PPV & NPV were 100%. CONCLUSION Tuberculosis is a global pandemic. Rapid identification of MTB culture isolate is very important for drug susceptibility testing. MPT 64 TB Ag detection ICT kit is a rapid, reliable method; it can be a substitute for the molecular identification methods.
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Affiliation(s)
- Vijay Gs Kumar
- Professor & Head of Clinical Microbiology, JSS Medical College, Mysore, 570 015, India.
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Assessment of the SD Bioline Ag MPT64 Rapid™ and the MGIT™ TBc identification tests for the diagnosis of tuberculosis. Diagn Microbiol Infect Dis 2011; 70:154-6. [PMID: 21397427 DOI: 10.1016/j.diagmicrobio.2010.12.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 12/05/2010] [Accepted: 12/10/2010] [Indexed: 11/21/2022]
Abstract
Successful control of tuberculosis relies on the rapid detection of Mycobacterium tuberculosis. Few chromatographic lateral flow assays for the discrimination of the M. tuberculosis complex were developed from culture media. We compared the values of 2 assays to assess their place in diagnosis of tuberculosis. We conclude of their efficiency and relevance to supplant the conventional methods.
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Martin A, Bombeeck D, Fissette K, de Rijk P, Hernández-Neuta I, Del Portillo P, Palomino JC. Evaluation of the BD MGIT TBc Identification Test (TBc ID), a rapid chromatographic immunoassay for the detection of Mycobacterium tuberculosis complex from liquid culture. J Microbiol Methods 2011; 84:255-7. [DOI: 10.1016/j.mimet.2010.12.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 11/17/2010] [Accepted: 12/02/2010] [Indexed: 11/30/2022]
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31
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Evaluation of the rapid MGIT TBc identification test for culture confirmation of Mycobacterium tuberculosis complex strain detection. J Clin Microbiol 2010; 49:802-7. [PMID: 21191055 DOI: 10.1128/jcm.02243-10] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A culture confirmation test for the detection of Mycobacterium tuberculosis complex strains that uses a lateral-flow immunochromatographic assay to detect the MPB64 antigen, the MGIT TBc identification (TBc ID) test, has been developed. We evaluated the performance of the TBc ID test in the detection of the M. tuberculosis complex in 222 primary-positive liquid cultures. We compared these results to those of nucleic acid-based identification and conventional biochemical tests. The validity of the TBc ID test was determined, and all of the nontuberculous mycobacteria (NTM) and Nocardia species tested were found to be negative. The detection limit of the TBc ID test was 5 × 10(5) CFU/ml, and for IS6110 real-time PCR it was 5 CFU/ml. All of the M. tuberculosis and M. africanum cultures were found to be positive, while M. bovis and M. bovis BCG cultures were negative. With the exception of 1 contaminated culture, the 221 culture-positive isolates contained 171 (77.5%) M. tuberculosis isolates, 39 (17.6%) NTM species, and 11 (5.0%) unidentified species. Two culture-positive isolates harbored a 63-bp deletion at position 196 of the mpb64 gene. The sensitivity, specificity, positive predictive values, and negative predictive values of the TBc ID test were 98.8, 100, 100, and 95.1%, respectively. Furthermore, the approximate turnaround time for real-time PCR was 4 h (including buffer and sample preparation), while for the TBc ID test it was less than 1 h. We suggest an algorithm for the primary identification of M. tuberculosis in liquid culture using the TBc ID test as an alternative to conventional subculture followed by identification using biochemical methods.
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32
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Evaluation of the Capilia TB assay for culture confirmation of Mycobacterium tuberculosis infections in Zambia and South Africa. J Clin Microbiol 2010; 48:3773-5. [PMID: 20686084 DOI: 10.1128/jcm.01688-09] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The performance and cost of the Capilia TB assay were evaluated for use in a resource-limited setting. The sensitivity and specificity were 99.6% and 99.5%, respectively. The incremental costs of the Capilia test were estimated to be $1.46 and $1.84 when the test was added to liquid and solid culture processes, respectively. These findings suggest that the Capilia TB assay represents a rapid, simple, and inexpensive Mycobacterium tuberculosis identification test that can be used in resource-limited settings.
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33
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Gopinath K, Singh S. Non-tuberculous mycobacteria in TB-endemic countries: are we neglecting the danger? PLoS Negl Trop Dis 2010; 4:e615. [PMID: 20436962 PMCID: PMC2860495 DOI: 10.1371/journal.pntd.0000615] [Citation(s) in RCA: 105] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- Krishnamoorthy Gopinath
- Division of Clinical Microbiology, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
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34
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Pai M, Minion J, Sohn H, Zwerling A, Perkins MD. Novel and Improved Technologies for Tuberculosis Diagnosis: Progress and Challenges. Clin Chest Med 2009; 30:701-16, viii. [DOI: 10.1016/j.ccm.2009.08.016] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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