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Shield CG, Swift BMC, McHugh TD, Dedrick RM, Hatfull GF, Satta G. Application of Bacteriophages for Mycobacterial Infections, from Diagnosis to Treatment. Microorganisms 2021; 9:2366. [PMID: 34835491 PMCID: PMC8617706 DOI: 10.3390/microorganisms9112366] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 01/09/2023] Open
Abstract
Mycobacterium tuberculosis and other non-tuberculous mycobacteria are responsible for a variety of different infections affecting millions of patients worldwide. Their diagnosis is often problematic and delayed until late in the course of disease, requiring a high index of suspicion and the combined efforts of clinical and laboratory colleagues. Molecular methods, such as PCR platforms, are available, but expensive, and with limited sensitivity in the case of paucibacillary disease. Treatment of mycobacterial infections is also challenging, typically requiring months of multiple and combined antibiotics, with associated side effects and toxicities. The presence of innate and acquired drug resistance further complicates the picture, with dramatic cases without effective treatment options. Bacteriophages (viruses that infect bacteria) have been used for decades in Eastern Europe for the treatment of common bacterial infections, but there is limited clinical experience of their use in mycobacterial infections. More recently, bacteriophages' clinical utility has been re-visited and their use has been successfully demonstrated both as diagnostic and treatment options. This review will focus specifically on how mycobacteriophages have been used recently in the diagnosis and treatment of different mycobacterial infections, as potential emerging technologies, and as an alternative treatment option.
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Affiliation(s)
- Christopher G. Shield
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield AL9 7TA, UK;
| | - Benjamin M. C. Swift
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield AL9 7TA, UK;
| | - Timothy D. McHugh
- Centre for Clinical Microbiology, University College London, London NW3 2PF, UK; (T.D.M.); (G.S.)
| | - Rebekah M. Dedrick
- Biological Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA; (R.M.D.); (G.F.H.)
| | - Graham F. Hatfull
- Biological Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA; (R.M.D.); (G.F.H.)
| | - Giovanni Satta
- Centre for Clinical Microbiology, University College London, London NW3 2PF, UK; (T.D.M.); (G.S.)
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Li X, He Y, Wang Z, Wei J, Hu T, Si J, Tao G, Zhang L, Xie L, Abdalla AE, Wang G, Li Y, Teng T. A combination therapy of Phages and Antibiotics: Two is better than one. Int J Biol Sci 2021; 17:3573-3582. [PMID: 34512166 PMCID: PMC8416725 DOI: 10.7150/ijbs.60551] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/01/2021] [Indexed: 12/15/2022] Open
Abstract
Emergence of antibiotic resistance presents a major setback to global health, and shortage of antibiotic pipelines has created an urgent need for development of alternative therapeutic strategies. Bacteriophage (phage) therapy is considered as a potential approach for treatment of the increasing number of antibiotic-resistant pathogens. Phage-antibiotic synergy (PAS) refers to sublethal concentrations of certain antibiotics that enhance release of progeny phages from bacterial cells. A combination of phages and antibiotics is a promising strategy to reduce the dose of antibiotics and the development of antibiotic resistance during treatment. In this review, we highlight the state-of-the-art advancements of PAS studies, including the analysis of bacterial-killing enhancement, bacterial resistance reduction, and anti-biofilm effect, at both in vitro and in vivo levels. A comprehensive review of the genetic and molecular mechanisms of phage antibiotic synergy is provided, and synthetic biology approaches used to engineer phages, and design novel therapies and diagnostic tools are discussed. In addition, the role of engineered phages in reducing pathogenicity of bacteria is explored.
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Affiliation(s)
- Xianghui Li
- Institute of Biomedical Informatics, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China
| | - Yuhua He
- Institute of Biomedical Informatics, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China.,Henan International Joint Laboratory of Nuclear Protein Regulation, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China
| | - Zhili Wang
- Institute of Biomedical Informatics, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China.,Henan International Joint Laboratory of Nuclear Protein Regulation, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China
| | - Jiacun Wei
- Institute of Biomedical Informatics, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China.,Henan International Joint Laboratory of Nuclear Protein Regulation, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China
| | - Tongxin Hu
- Institute of Biomedical Informatics, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China.,Henan International Joint Laboratory of Nuclear Protein Regulation, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China
| | - Jiangzhe Si
- Institute of Biomedical Informatics, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China.,Henan International Joint Laboratory of Nuclear Protein Regulation, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China
| | - Guangzhao Tao
- Institute of Biomedical Informatics, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China.,Henan International Joint Laboratory of Nuclear Protein Regulation, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China
| | - Lei Zhang
- Institute of Biomedical Informatics, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China.,Henan International Joint Laboratory of Nuclear Protein Regulation, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China
| | - Longxiang Xie
- Institute of Biomedical Informatics, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China.,Henan International Joint Laboratory of Nuclear Protein Regulation, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China
| | - Abualgasim Elgaili Abdalla
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 2014, Saudi Arabia
| | - Guoying Wang
- Institute of Biomedical Informatics, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China.,Henan International Joint Laboratory of Nuclear Protein Regulation, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China
| | - Yanzhang Li
- Institute of Biomedical Informatics, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China.,Henan International Joint Laboratory of Nuclear Protein Regulation, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China
| | - Tieshan Teng
- Institute of Biomedical Informatics, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China.,Henan International Joint Laboratory of Nuclear Protein Regulation, school of Basic Medical Sciences, Henan University, Kaifeng 475004, China
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Harada LK, Júnior WB, Silva EC, Oliveira TJ, Moreli FC, Júnior JMO, Tubino M, Vila MMDC, Balcão VM. Bacteriophage-Based Biosensing of Pseudomonas aeruginosa: An Integrated Approach for the Putative Real-Time Detection of Multi-Drug-Resistant Strains. BIOSENSORS-BASEL 2021; 11:bios11040124. [PMID: 33921071 PMCID: PMC8071457 DOI: 10.3390/bios11040124] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/03/2021] [Accepted: 04/13/2021] [Indexed: 12/19/2022]
Abstract
During the last decennium, it has become widely accepted that ubiquitous bacterial viruses, or bacteriophages, exert enormous influences on our planet’s biosphere, killing between 4–50% of the daily produced bacteria and constituting the largest genetic diversity pool on our planet. Currently, bacterial infections linked to healthcare services are widespread, which, when associated with the increasing surge of antibiotic-resistant microorganisms, play a major role in patient morbidity and mortality. In this scenario, Pseudomonas aeruginosa alone is responsible for ca. 13–15% of all hospital-acquired infections. The pathogen P. aeruginosa is an opportunistic one, being endowed with metabolic versatility and high (both intrinsic and acquired) resistance to antibiotics. Bacteriophages (or phages) have been recognized as a tool with high potential for the detection of bacterial infections since these metabolically inert entities specifically attach to, and lyse, bacterial host cells, thus, allowing confirmation of the presence of viable cells. In the research effort described herein, three different phages with broad lytic spectrum capable of infecting P. aeruginosa were isolated from environmental sources. The isolated phages were elected on the basis of their ability to form clear and distinctive plaques, which is a hallmark characteristic of virulent phages. Next, their structural and functional stabilization was achieved via entrapment within the matrix of porous alginate, biopolymeric, and bio-reactive, chromogenic hydrogels aiming at their use as sensitive matrices producing both color changes and/or light emissions evolving from a reaction with (released) cytoplasmic moieties, as a bio-detection kit for P. aeruginosa cells. Full physicochemical and biological characterization of the isolated bacteriophages was the subject of a previous research paper.
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Affiliation(s)
- Liliam K. Harada
- PhageLab—Laboratory of Biofilms and Bacteriophages, University of Sorocaba, Sorocaba, SP 18023-000, Brazil; (L.K.H.); (E.C.S.); (T.J.O.); (F.C.M.); (J.M.O.J.); (M.M.D.C.V.)
| | | | - Erica C. Silva
- PhageLab—Laboratory of Biofilms and Bacteriophages, University of Sorocaba, Sorocaba, SP 18023-000, Brazil; (L.K.H.); (E.C.S.); (T.J.O.); (F.C.M.); (J.M.O.J.); (M.M.D.C.V.)
| | - Thais J. Oliveira
- PhageLab—Laboratory of Biofilms and Bacteriophages, University of Sorocaba, Sorocaba, SP 18023-000, Brazil; (L.K.H.); (E.C.S.); (T.J.O.); (F.C.M.); (J.M.O.J.); (M.M.D.C.V.)
| | - Fernanda C. Moreli
- PhageLab—Laboratory of Biofilms and Bacteriophages, University of Sorocaba, Sorocaba, SP 18023-000, Brazil; (L.K.H.); (E.C.S.); (T.J.O.); (F.C.M.); (J.M.O.J.); (M.M.D.C.V.)
| | - José M. Oliveira Júnior
- PhageLab—Laboratory of Biofilms and Bacteriophages, University of Sorocaba, Sorocaba, SP 18023-000, Brazil; (L.K.H.); (E.C.S.); (T.J.O.); (F.C.M.); (J.M.O.J.); (M.M.D.C.V.)
| | - Matthieu Tubino
- Institute of Chemistry, University of Campinas, Campinas, SP 13083-970, Brazil;
| | - Marta M. D. C. Vila
- PhageLab—Laboratory of Biofilms and Bacteriophages, University of Sorocaba, Sorocaba, SP 18023-000, Brazil; (L.K.H.); (E.C.S.); (T.J.O.); (F.C.M.); (J.M.O.J.); (M.M.D.C.V.)
| | - Victor M. Balcão
- PhageLab—Laboratory of Biofilms and Bacteriophages, University of Sorocaba, Sorocaba, SP 18023-000, Brazil; (L.K.H.); (E.C.S.); (T.J.O.); (F.C.M.); (J.M.O.J.); (M.M.D.C.V.)
- Department of Biology and CESAM, University of Aveiro, Campus Universitário de Santiago, P-3810-193 Aveiro, Portugal
- Correspondence: ; Tel.: +55-(15)-2101-7029
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Abedon ST. Phage-Antibiotic Combination Treatments: Antagonistic Impacts of Antibiotics on the Pharmacodynamics of Phage Therapy? Antibiotics (Basel) 2019; 8:antibiotics8040182. [PMID: 31614449 PMCID: PMC6963693 DOI: 10.3390/antibiotics8040182] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 12/12/2022] Open
Abstract
Bacteria can evolve resistance to antibiotics. Even without changing genetically, bacteria also can display tolerance to antibiotic treatments. Many antibiotics are also broadly acting, as can result in excessive modifications of body microbiomes. Particularly for antibiotics of last resort or in treating extremely ill patients, antibiotics furthermore can display excessive toxicities. Antibiotics nevertheless remain the standard of care for bacterial infections, and rightly so given their long track records of both antibacterial efficacy and infrequency of severe side effects. Antibiotics do not successfully cure all treated bacterial infections, however, thereby providing a utility to alternative antibacterial approaches. One such approach is the use of bacteriophages, the viruses of bacteria. This nearly 100-year-old bactericidal, anti-infection technology can be effective against antibiotic-resistant or -tolerant bacteria, including bacterial biofilms and persister cells. Ideally phages could be used in combination with standard antibiotics while retaining their anti-bacterial pharmacodynamic activity, this despite antibiotics interfering with aspects of bacterial metabolism that are also required for full phage infection activity. Here I examine the literature of pre-clinical phage-antibiotic combination treatments, with emphasis on antibiotic-susceptible bacterial targets. I review evidence of antibiotic interference with phage infection activity along with its converse: phage antibacterial functioning despite antibiotic presence.
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Affiliation(s)
- Stephen T Abedon
- Department of Microbiology, The Ohio State University, Mansfield, OH 44906, USA.
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Sorokulova I, Olsen E, Vodyanoy V. Bacteriophage biosensors for antibiotic-resistant bacteria. Expert Rev Med Devices 2014; 11:175-86. [DOI: 10.1586/17434440.2014.882767] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Balcão VM, Moreira AR, Moutinho CG, Chaud MV, Tubino M, Vila MMDC. Structural and functional stabilization of phage particles in carbohydrate matrices for bacterial biosensing. Enzyme Microb Technol 2013; 53:55-69. [PMID: 23683705 DOI: 10.1016/j.enzmictec.2013.03.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 02/27/2013] [Accepted: 03/02/2013] [Indexed: 12/15/2022]
Abstract
Infections associated with health care services are nowadays widespread and, associated to the progressive emergence of microorganisms resistant to conventional chemical antibiotics, are major causes of morbidity and mortality. One of the most representative microorganisms in this scenario is the bacterium Pseudomonas aeruginosa, which alone is responsible for ca. 13-15% of all nosocomial infections. Bacteriophages have been reported as a potentially useful tool in the diagnosis of bacterial diseases, since they specifically recognize and lyse bacterial isolates thus confirming the presence of viable cells. In the present research effort, immobilization of these biological (although metabolically inert) entities was achieved via entrapment within (optimized) porous (bio)polymeric matrices of alginate and agar, aiming at their full structural and functional stabilization. Such phage-impregnated polymeric matrices are intended for future use as chromogenic hydrogels sensitive to color changes evolving from reaction with (released) intracytoplasmatic moieties, as a detection kit for P. aeruginosa cells.
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Affiliation(s)
- Victor M Balcão
- Bioengineering and Biopharmaceutical Chemistry Research Group, University Fernando Pessoa, Rua Carlos da Maia n° 296, P-4200-150 Porto, Portugal.
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Chang KC, Yew WW, Zhang Y. A systematic review of rapid drug susceptibility tests for multidrug-resistant tuberculosis using rifampin resistance as a surrogate. ACTA ACUST UNITED AC 2013; 3:99-122. [PMID: 23485158 DOI: 10.1517/17530050802665694] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The emergence of multidrug-resistant tuberculosis (MDR-TB) has prompted the development of rapid drug susceptibility assays with a focus on rifampin in recent years. Systematic reviews with evaluation of predictive values for different assays are scarce. METHOD MEDLINE was searched on 6 September 2008 for English articles that contain concurrent original data for generating summary measures of sensitivity, specificity and likelihood ratios of rapid rifampin susceptibility assays. RESULTS/CONCLUSIONS Significant heterogeneity was found in likelihood ratios across studies of all assays except nitrate reductase assay and colorimetric assays. Although rapid assays are fairly reliable for ruling out MDR-TB, careful consideration of clinical risk factors is required before using these assays to rule in MDR-TB under different epidemiological settings.
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Affiliation(s)
- Kwok-Chiu Chang
- Senior Medical and Health Officer Tuberculosis and Chest Service, Wanchai Chest Clinic, Department of Health, 1st Floor, Wanchai Polyclinic, 99, Kennedy Road, Wanchai, Hong Kong, China +852 25911147 ; +852 28346627 ;
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Hemvani N, Patidar V, Chitnis D. In-house, simple & economical phage technique for rapid detection of rifampicin, isoniazid, ethambutol, streptomycin & ciprofloxacin drug resistance using Mycobacterium tuberculosis isolates. Indian J Med Res 2012; 135:783-7. [PMID: 22771613 PMCID: PMC3401714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND & OBJECTIVES Multiple drug resistance (MDR) among Mycobacterium tuberculosis poses a serious therapeutic problem. Early detection of MDR can be valuable but the conventional drug susceptibility tests take 4-6 wk time after the laboratory isolation of M. tuberculosis. The bacterial phage assay has been reported as a rapid tool for rifampicin susceptibility testing of tubercle bacilli using the suspension of isolated cultures. The present study was aimed to set up a phage assay for testing drug susceptibility to isoniazid (INH), rifampicin, ethambutol, streptomycin and ciprofloxacin in M. tuberculosis isolates. METHODS Mueller-Hinton broth instead of Middle Brook 7H9 broth was used to make it more economical. The phage assay was compared with the proportion method using 100 M. tuberculosis isolates from pulmonery TB cases. Phage assay results were available in 48 h for rifampicin and streptomycin while 72 h required for INH, ethambutol and ciprofloxacin. The assay was compared with gold standard proportion method. Interpretation of the results was easy and clear. RESULTS In the present study, sensitivity and specificity of the phage assay when compared to proportion method were in the range of 97 to 100 per cent for all the drugs except for ciprofloxacin for which it was 93 and 96 per cent, respectively. INTERPRETATION & CONCLUSIONS The phage assay was economic, easy to perform and rapid for the detection of drug resistance in M. tuberculosis isolates with no requirement of expensive equipment. It is within the reach of microbiology laboratories in developing countries having high loads of tuberculosis.
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Affiliation(s)
- Nanda Hemvani
- Department of Microbiology, Immunology & Molecular Biology, Choithram Hospital & Research Centre, Indore, India
| | - Vikas Patidar
- Department of Microbiology, Immunology & Molecular Biology, Choithram Hospital & Research Centre, Indore, India
| | - D.S. Chitnis
- Department of Microbiology, Immunology & Molecular Biology, Choithram Hospital & Research Centre, Indore, India,Reprint requests: Dr D.S. Chitnis, Department of Microbiology, Immunology & Molecular biology, Intermediate Referral Laboratory for Mycobacteriology, Choithram Hospital & Research Centre, Manik Bagh Road, Indore 452 014, India e-mail:
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Liu K, Wen Z, Li N, Yang W, Wang J, Hu L, Dong X, Lu J, Li J. Impact of relative humidity and collection media on mycobacteriophage D29 aerosol. Appl Environ Microbiol 2012; 78:1466-72. [PMID: 22194291 PMCID: PMC3294485 DOI: 10.1128/aem.06610-11] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Accepted: 12/12/2011] [Indexed: 01/21/2023] Open
Abstract
This study was conducted to evaluate the effect of aerosol generation, methods of sampling, storage conditions, and relative humidity on the culturability of the mycobacteriophage D29. The lytic phage D29 can kill Mycobacterium tuberculosis, and the phage aerosol can be treated as a potential tool for tuberculosis treatment. The culturability of D29 was tested using a test chamber designed for the bioaerosols research against three spray liquids (deionized water, phosphate-buffered saline [PBS], and normal saline), four collection media (suspension medium [SM], nutrient broth, PBS, and deionized water), two sampling systems (the all-glass impinger AGI-30 and the Biosampler) and across a range of humidities (20 to 90%). The effect of storage conditions on the culturability of collected sample was also evaluated for the AGI-30 impinger. The results proved that viable phage D29 particles generated by deionized water were approximately 30- and 300-fold higher than PBS and normal saline, respectively. As collection media, SM buffer and nutrient broth were observed to yield a higher number of plaques compared to PBS and deionized water. No difference was observed in collection efficiency between AGI-30 and Biosampler with two detection methods (culture-based technique and real-time PCR). The culturability of collected D29 in SM buffer or nutrient broth can be maintained up to 12 h irrespective of storage temperature. Relative humidity was found to strongly influence airborne D29 culturability which is 2- to 20-fold higher in low humidity (25%) than medium (55%) or high (85%) humidity. This research will help identify the optimal means for the application of D29 aerosol in animal inhalation experiments.
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Affiliation(s)
- Keyang Liu
- Beijing Institute of Microbiology andEpidemiology, Beijing, People's Republic of China
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Hemvani N, Patidar V, Chitnis DS. A simple and economical in-house phage technique for the rapid detection of rifampin, isoniazid, ethambutol, streptomycin, and ciprofloxacin drug resistance in Mycobacterium tuberculosis, directly on decontaminated sputum samples. Int J Infect Dis 2012; 16:e332-6. [PMID: 22369736 DOI: 10.1016/j.ijid.2011.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Revised: 11/26/2011] [Accepted: 12/20/2011] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The early detection of drug resistance would be a boon for TB control programs. The aim of the present study was to set up a rapid phage assay for the testing of drug susceptibility of Mycobacterium tuberculosis to rifampin, isoniazid, ethambutol, streptomycin, and ciprofloxacin, directly on decontaminated sputum samples. METHODS Mueller-Hinton broth was used instead of 7H9 broth to make the method more economical. Vancomycin and polymyxin B were added to the concentrated sputum samples to reduce the bacterial contamination. The phage assay on decontaminated sputum samples was compared with the proportion method using M. tuberculosis isolates from the same sputum samples. RESULTS Phage assay results were available within 48h for rifampin and streptomycin and within 72h for all the other drugs. In contrast the proportion method required 4-6 weeks from the primary cultures. The sensitivity of the phage assay was in the range of 93% to 100% and specificity in the range of 96% to 100% for all the drugs tested. The interpretation of results was possible for 334 of the 370 (90.3%) acid-fast bacillus (AFB) smear-positive sputum samples by the phage assay. CONCLUSIONS The phage assay for the detection of drug resistance on direct decontaminated sputum samples is economical, easy to perform, and rapid.
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Affiliation(s)
- Nanda Hemvani
- Department of Microbiology, Immunology and Molecular Biology, Intermediate Referral Laboratory for Mycobacteriology, Choithram Hospital and Research Centre, Manik Bagh Road, Indore, MP 452014, India
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Stella EJ, de la Iglesia AI, Morbidoni HR. Comparison of the performance of two mycobacteriophage D29-based protocols for fluoroquinolone susceptibility testing in Mycobacterium tuberculosis. J Microbiol Methods 2009; 79:371-3. [PMID: 19846046 DOI: 10.1016/j.mimet.2009.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2009] [Revised: 10/11/2009] [Accepted: 10/12/2009] [Indexed: 10/20/2022]
Abstract
We tested a mycobacteriophage D29-based method for fluoroquinolone susceptibility assessment in clinical isolates of Mycobacteriumtuberculosis. The method was incapable of identifying susceptible strains as such, although a slightly different published protocol successfully identified resistant and susceptible strains. Thus, caution is necessary when choosing an "in-house" D29-based protocol for testing of drug resistance.
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Affiliation(s)
- Emma J Stella
- Cátedra de Microbiología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, 2000 Rosario, Argentina
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Rapid culture-based methods for drug-resistance detection in Mycobacterium tuberculosis. J Microbiol Methods 2008; 75:161-6. [DOI: 10.1016/j.mimet.2008.06.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2008] [Revised: 06/02/2008] [Accepted: 06/20/2008] [Indexed: 11/19/2022]
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Abstract
Tests based on nucleic acid amplification can rapidly detect mycobacteria in clinical samples. These appear to be promising and may change how mycobacterial diseases are diagnosed in the future. Utilization of nucleic acid hybridization and DNA sequencing has enabled the identification of mycobacteria to the species level and detection of mutations associated with antimicrobial resistance. Combining nucleic acid amplification with genotypic identification methods allows detection and identification of mycobacteria directly in clinical samples and, to a limited extent, detection of antimicrobial resistance. IFN-gamma-based assays provide results faster than the tuberculin skin test and address many of its shortcomings, and are thus poised to replace the latter in the coming years.
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Affiliation(s)
- Nabin K Shrestha
- Cleveland Clinic, Infectious Diseases/S-32, Cleveland, OH 44195, USA.
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Abstract
Childhood tuberculosis (TB) has long been neglected by TB control programmes, as children tend to develop sputum smear-negative disease and rarely contribute to disease transmission. However, children suffer severe TB-related morbidity and mortality in areas with endemic TB and carry a significant proportion of the global disease burden. Apart from improved control of the global TB epidemic, access to accurate diagnosis and effective treatment is essential to reduce the disease burden associated with childhood TB. Access to child friendly anti-TB treatment is improving, but establishing an accurate diagnosis remains a challenge. This review provides an overview of recent advances in the diagnosis of childhood TB, focusing on bacteriological, immunological, radiological and symptom-based approaches. It is possible to establish a fairly accurate diagnosis of either latent infection or active TB in immunocompetent children, even in resource-limited settings, but establishing an accurate diagnosis of TB in HIV-infected (immunocompromised) children remains a major challenge.
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Affiliation(s)
- Ben J Marais
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Cape Town, South Africa.
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