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Wang WH, Lin CY, Jain SH, Lu PL, Chen YH. Development of the novel gene chip and restriction fragment length polymorphism (RFLP) methods for rapid detection of Mycobacterium tuberculosis complex in broth culture. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2024:S1684-1182(24)00181-6. [PMID: 39341698 DOI: 10.1016/j.jmii.2024.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 08/26/2024] [Accepted: 09/14/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND Tuberculosis (TB) is a major global public health issue. Prompt and accurate TB diagnosis is crucial for starting appropriate treatments and preventing the disease's spread. Current diagnostic techniques are either slow or expensive. This study aimed to create and evaluate a new, fast, highly reliable, and cost-effective TB detection method using a gene chip and Restriction Fragment Length Polymorphism (RFLP) analysis on Mycobacteria Growth Indicator Tubes (MGIT) specimens. METHODS We assessed the effectiveness of a novel gene chip and RFLP methods targeting the 16S rRNA gene of Mycobacterium tuberculosis in 2000 MGIT culture-positive specimens. RFLP analysis identified the AfeI restriction site within the M. tuberculosis complex (MTBC) genome. Discrepancies were investigated through extensive sequencing and Cobas TaqMan PCR analysis, along with reviewing patient profiles. RESULTS Both methods showed high efficacy in detecting MTBC in broth cultures, with the gene chip method achieving a sensitivity of 99.27 %, specificity of 98.35 %, and the RFLP method showing a sensitivity of 98.18 %, specificity of 99.31 %. False negatives in two isolates were due to a mutation in the AfeI site. Additionally, five cases showed MTBC presence when nontuberculous Mycobacterium species grew in cultures. CONCLUSION Our novel gene chip and RFLP methods are effective for rapid highly-reliable and cost-effective M. tuberculosis detection in MGIT specimens. Both gene chip and RFLP methods are suitable for resource-limited settings, offering an economical advantage. These methods have significant potential to improve clinical TB diagnosis.
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Affiliation(s)
- Wen-Hung Wang
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine, Graduate Institute of Medicine, Center of Tropical Medicine and Infectious Diseases, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Chun-Yu Lin
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine, Graduate Institute of Medicine, Center of Tropical Medicine and Infectious Diseases, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Shu-Huei Jain
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Po-Liang Lu
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine, Graduate Institute of Medicine, Center of Tropical Medicine and Infectious Diseases, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Yen-Hsu Chen
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine, Graduate Institute of Medicine, Center of Tropical Medicine and Infectious Diseases, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Biological Science and Technology, College of Biological Science and Technology, National Yang Ming Chiao Tung University, HsinChu, Taiwan.
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Song Z, He W, Pei S, Zhao B, Cao X, Wang Y, He P, Liu D, Ma A, Ou X, Xia H, Wang S, Liu C, Zhao Y. Association of lineage 4.2.2 of Mycobacterium tuberculosis with the 63-bp deletion variant of the mpt64 gene. Microbiol Spectr 2023; 11:e0184223. [PMID: 37947405 PMCID: PMC10714870 DOI: 10.1128/spectrum.01842-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 10/03/2023] [Indexed: 11/12/2023] Open
Abstract
IMPORTANCE To date, rapid diagnostic methods based on the MPT64 antigen assay are increasingly utilized to differentiate between non-tuberculous mycobacteria and TB disease in clinical settings. Furthermore, numerous novel techniques based on the MPT64 release assay are continuously being developed and applied for the identification of both pulmonary and extrapulmonary TB. However, the diagnostic accuracy of the MPT64 antigen assay is influenced by the presence of 63 bp deletion variants within the mpt64 gene. To our knowledge, this is the first report on the association between the 63 bp deletion variant in mpt64 and Mycobacterium tuberculosis L4.2.2 globally, which highlights the need for the cautious utilization of MPT64-based testing in regions where L4.2.2 isolates are prevalent, such as China and Vietnam, and MPT64 negative results should be confirmed with another assay. In addition, further studies on vaccine development and immunology based on MPT64 should consider these isolates with 63 bp deletion variant.
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Affiliation(s)
- Zexuan Song
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wencong He
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shaojun Pei
- School of Public Health, Peking University, Beijing, China
| | - Bing Zhao
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaolong Cao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yiting Wang
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ping He
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dongxin Liu
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Aijing Ma
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xichao Ou
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hui Xia
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shengfen Wang
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chunfa Liu
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China
- Animal Science and Technology College, Beijing University of Agriculture, Beijing, China
| | - Yanlin Zhao
- National Tuberculosis Reference Laboratory, Chinese Center for Disease Control and Prevention, Beijing, China
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Abebaw Y, Abebe M, Tola HH, Mehammed Z, Getahun M, Gamtesa DF, Diriba G, Hailu M, Yirgu H, Sheth AN, Argaw R, Abegaz WE. Pulmonary tuberculosis case notification and burden of drug resistance among children under 15 years of age in Ethiopia: sub-analysis from third-round drug resistance tuberculosis survey. BMC Pediatr 2023; 23:418. [PMID: 37620787 PMCID: PMC10463301 DOI: 10.1186/s12887-023-04240-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
INTRODUCTION Data on the burden of bacteriologically confirmed childhood Tuberculosis (PTB) and drug-resistant TB in Ethiopia is limited due to difficulties related to its diagnosis in this population. Therefore, this study aimed to assess bacteriologically confirmed childhood PTB Case Notification Rates (CNRs) and the burden of Drug Resistant-Tuberculosis among children in Ethiopia. METHOD Retrospective secondary clinical and laboratory data were obtained from 3rd round national DR-TB survey which was conducted between August 2017 and January 2019. We used IBM SPSS 24 for sub-analysis of 3rd round Drug Resistant-Tuberculosis data. Descriptive statistics were used in computing the association between the sociodemographic characteristics and PTB CNRs, and the strength of the associations was determined using binary logistic regression with Odds ratios (OR) with a 95% confidence interval (CI). RESULT Overall, 102 bacteriologically confirmed childhood PTB cases were identified with a median age of 12 (range 1-14) years. Of these, 54 (52.9%) were females and 81 (79.4%) lived in rural areas. HIV-TB co-infection cases were 5/102 (4.3%) and the majority (98%) of cases were newly diagnosed children. Nationally, the incidence of bacteriologically confirmed childhood PTB was calculated to be 5.1 per 100,000 children. The burden of Drug Resistant-Tuberculosis to at least one of the five first-line anti-TB drugs tested was five (6.5%) cases and one (1.3%) was found to be a Multi-drug resistant tuberculosis case. Drug-resistant tuberculosis was significantly associated with the age group 10-14 years (P = 0.002; [AOR] 29.76; [95% CI, 3.51-252.64]) and children living in urban areas (P = 0.027; [AOR] 5.76; 95% CI, 1.22-27.09). CONCLUSION Bacteriologically confirmed childhood PTB cases increased as the age of the children increased. Most of the bacteriologically confirmed childhood PTB and the identified drug Resistant-Tuberculosis cases were new cases. Also, rural children were more affected by TB than their urban, counterparts Drug Resistant-Tuberculosis was higher in urban resident children.
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Affiliation(s)
- Yeshiwork Abebaw
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University and Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Markos Abebe
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | | | | | | | | | - Getu Diriba
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Michael Hailu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Anandi Nayan Sheth
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Rahel Argaw
- Department of Pediatrics and Child Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Woldaregay Erku Abegaz
- Department of Microbiology, Immunology and Parasitology, College of Health Sciences, Addis Ababa University and Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Zhu Y, Hua W, Liu Z, Zhang M, Wang X, Wu B, Wang Z, Chen J. Identification and characterization of nontuberculous mycobacteria isolated from suspected pulmonary tuberculosis patients in eastern china from 2009 to 2019 using an identification array system. Braz J Infect Dis 2022; 26:102346. [PMID: 35288106 PMCID: PMC9387452 DOI: 10.1016/j.bjid.2022.102346] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/27/2022] [Accepted: 02/21/2022] [Indexed: 12/11/2022] Open
Abstract
Objective Nontuberculous mycobacteria (NTM) species are increasingly being isolated and have become a key factor affecting public health by causing pulmonary diseases. Most NTM species do not respond to conventional tuberculosis (TB) drugs. This study aimed to identify NTM isolated from suspected pulmonary TB patients from the Zhejiang province and analyze their distribution in the region. Methods A total of 1,113 NTM isolates from patients suspected to be suffering from acid-fast bacilli-positive tuberculosis were identified at the species level, using the CapitalBio Mycobacterium identification array and polymerase chain reaction amplification and sequencing of 16S-23S gene internal transcribed spacer (ITS), 16S rRNA, and hsp65. Results Of the 23,138 isolates, we identified 1,102 NTM (4.8%), mainly including Mycobacterium intracellulare (54.81%, 604/1,102), M. chelonae-M. abscessus (16.52%, 182/1,102), M. avium (13.16%, 145/1,102), M. kansasii (8.17%, 90/1,102), and M. gordonae (3.27%, 36/1,102). Conclusion The distribution of NTM species observed in patients with suspected pulmonary tuberculosis provides guidance for the diagnosis and treatment of NTM pulmonary diseases.
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Affiliation(s)
- Yelei Zhu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Wenya Hua
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhengwei Liu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Mingwu Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xiaomeng Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Beibei Wu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Zhen Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
| | - Jiazhen Chen
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.
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Clinical Validation of the Xpert MTB/RIF test for Identification of the MTB Complex in AFB Smear-Positive MGIT broth cultures. J Clin Microbiol 2022; 60:e0216421. [PMID: 34985982 DOI: 10.1128/jcm.02164-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The identification of the M. tuberculosis complex (MTBC) from smear positive broth cultures can be achieved using several methods including both lab-developed and commercially available molecular assays. In the United States, a commercially available probe-based assay has been used for over a decade by many laboratories for identification of MTBC directly from AFB smear positive broth cultures, including those recovered from the MGIT 960 system. However, recent difficulties in obtaining probe kits for identification resulted in mycobacteriology laboratories looking for alternative platforms to provide for rapid identification of MTBC and detection of rifampicin resistance. The Xpert® MTB/RIF test (Cepheid, Sunnyvale, Ca) has shown high sensitivity for the diagnosis of MTBC from pulmonary specimens but is not often used for identification directly from smear positive, MGIT 960 broth cultures (Becton Dickinson, Sparks, Md). We sought to validate the Xpert MTB/RIF test for use with AFB smear positive MGIT 960 cultures in a clinical hospital setting. Overall, the assay showed a categorical agreement of 100% for identification of MTBC and detection of rifampin resistance. No false positive results or cross-reactivity were noted. Findings indicate that the Xpert MTB/RIF test may be suitable as a rapid replacement for identification of MTBC and detection of rifampicin resistance from AFB smear positive MGIT 960 broth cultures.
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Bai W, Liu L, Wu L, Chen S, Wu S, Wang Z, Xu K, Chi Q, Pan Y, Xu X. Assessing the utility of the Xpert Mycobacterium tuberculosis/rifampin assay for analysis of bronchoalveolar lavage fluid in patients with suspected pulmonary tuberculosis. J Clin Lab Anal 2021; 36:e24154. [PMID: 34850984 PMCID: PMC8761447 DOI: 10.1002/jcla.24154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/09/2021] [Accepted: 11/17/2021] [Indexed: 11/20/2022] Open
Abstract
Background There is limited research assessing the utility of the Xpert Mycobacterium tuberculosis/rifampin (MTB/RIF) assay for the analysis of bronchoalveolar lavage fluid (BALF) in Chinese patients with suspected pulmonary tuberculosis (PTB). Thus, our objective was to determine the diagnostic accuracy of the Xpert MTB/RIF assay and evaluate its utility for the determination of rifampicin resistance. Methods We retrospectively analyzed BALF from 214 patients with suspected PTB between January 2018 and March 2019. Using mycobacterial culture or final clinical diagnosis as the reference standard, the diagnostic accuracy of the smear microscopy (SM), tuberculosis bacillus DNA (TB‐DNA), Xpert MTB/RIF assay, and the determination of rifampicin resistance based on the Xpert MTB/RIF assay were compared. Results As compared to mycobacterial culture, the sensitivity of the Xpert MTB/RIF assay, SM, and TB‐DNA were 85.5% (74.2%–93.1%), 38.7% (26.6%–51.9%), and 67.7% (54.7%–79.1%), respectively. As compared to the final diagnosis, the specificity of the Xpert MTB/RIF assay, SM, and TB‐DNA were 100.0% (95.9%–100.0%), 94.3% (87.1%–98.1%), and 98.9% (93.8%–100.0%), respectively. The sensitivity and specificity of the rifampicin resistance detection using the Xpert MTB/RIF assay were 100% and 98.0%, respectively, with liquid culture as the reference. Conclusions This study demonstrates that the analysis of BALF with the Xpert MTB/RIF assay provides a rapid and accurate tool for the early diagnosis of PTB. The accuracy of diagnosis was superior compared with the SM and TB‐DNA. Moreover, Xpert is a quick and accurate method for the diagnosis of rifampicin‐resistant tuberculosis and can also provide more effective guidance for the treatment of PTB or multidrug‐resistant tuberculosis (MDR‐TB).
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Affiliation(s)
- Wenjing Bai
- Department of Clinical Laboratory Medicine, Wenzhou Central Hospital, Wenzhou, China
| | - Lingling Liu
- Department of Clinical Laboratory Medicine, Wenzhou Longwan First People's Hospital, Wenzhou, China
| | - Lianpeng Wu
- Department of Clinical Laboratory Medicine, Wenzhou Central Hospital, Wenzhou, China
| | - Shanshan Chen
- Department of Blood Transfusion, People's Hospital of Pingyang County, Wenzhou, China
| | - Shuangliao Wu
- Department of Clinical Laboratory Medicine, Wenzhou Central Hospital, Wenzhou, China
| | - Zhihui Wang
- Department of Obstetrics and Gynecology, Wenzhou Central Hospital, Wenzhou, China
| | - Ke Xu
- Department of Clinical Laboratory Medicine, Wenzhou Central Hospital, Wenzhou, China
| | - Qiong Chi
- Department of Respiratory and Critical Care Medicine, Key Laboratory of precision medicine of Wenzhou, Wenzhou Central Hospital, Wenzhou, China
| | - Yong Pan
- Department of Clinical Laboratory Medicine, Key Laboratory of precision medicine of Wenzhou, Wenzhou Central Hospital, Wenzhou, China
| | - Xueqin Xu
- Department of Clinical Laboratory Medicine, Key Laboratory of precision medicine of Wenzhou, Wenzhou Central Hospital, Wenzhou, China
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Ogwang MO, Imbuga M, Ngugi C, Mutharia L, Magoma G, Diero L. Distribution patterns of drug resistance Mycobacterium tuberculosis among HIV negative and positive tuberculosis patients in Western Kenya. BMC Infect Dis 2021; 21:1175. [PMID: 34809602 PMCID: PMC8607708 DOI: 10.1186/s12879-021-06887-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Globally anti-tuberculosis drug resistance is one of the major challenges affecting control and prevention of tuberculosis. Kenya is ranked among 30 high burden TB countries globally. However, there is scanty information on second line antituberculosis drug resistance among tuberculosis patients. Therefore, this study aimed at determining Mycobacterium tuberculosis drug resistant strain distribution pattern in 10 counties of Western Kenya among HIV positive and negative patients. METHOD A cross-sectional study was conducted in Western Kenya, which comprises 10 counties. A multistage sampling method was used where a single sub-county was randomly selected followed by sampling one high volume health facility from each sub-county. Consenting study subjects with at least two smear positive sputum at the time of enrolment were randomly selected. The collected sputum was decontaminated with N-acetyl-L-cysteine-sodium hydroxide (NALC-NaOH) and then stained with Ziehl Neelsen Stain before visualizing the presence of bacilli under microscope at ×100 magnification with oil immersion. Further, the identified bacilli were cultured and susceptibility test carried out using known first and second line antimycobacterial tuberculosis. HIV testing was carried out using Determine® HIV-1/2 rapid test (Abbot Diagnostics, Maidenhead, United Kingdom). Those who had smear converted were dropped from the study. Finally, drug susceptibility pattern across the 10 counties of Western Kenya was evaluated. RESULTS Our study showed that Mycobacterium tuberculosis drug resistance among HIV negative and positive cases in Western Kenya was prevalent in all the 10 counties surveyed. Based on the drug susceptibility tests, 53.2% and 42.7% of the study samples were resistant to at least one antituberculosis drug among HIV negative and HIV positive patients respectively. The data analysis revealed that among the HIV-positive and HIV-negative patients, resistance to INH was predominant (28.5%, and 23.6%, respectively), followed by RIF (16.4% and 14.6% respectively). Second-line drug resistant strains identified among HIV negative patients included Ethionamide (0.3%), Gatifloxacin (0.3%), Amikacin (0.3%) and Capreomycin (0.3%). There was no second line drug monoresistance among HIV positive TB patients. Multi/poly drug resistance were noted among HIV-negative patients in, INH + AMK (0.7%), INH + PZA (1%), INH + GFX (0.7%, INH + ETO (0.7%, STY + ETO (1%), ETH + ETO (1.0%), INH + KAN (0.7%) and INH + CAP (0.7%) strains/cases at 95% confidence interval. Among HIV positive patients INH + GFX (1.1%), INH + ETO (0.4%) and INH + KAN (0.4%) strains of M. tuberculosis were identified with a confidence interval of 95%. Geographical distribution patterns analysis of M. tuberculosis drug polyresistant strains across the 10 counties were recorded. Among HIV TB patients, resistant strains were identified in Nyamira (INH + GFX, INH + KAN), Bungoma ((ETO + STY), Busia (ETH + ETO and STY + ETO) Homabay (RIF + AMK. ETO + ETH and ETO + STY), Kisumu (ETH + ETO and PZA + ETO) and in Kakamega, Kisii and Vihiga (INH + KAN and RIF + AMK). There was no M. tuberculosis polyresistant strain identified in Migori and Siaya counties. Among HIV positive TB patients, M. tuberculosis resistant strains were identified in three counties, Nyamira (INH + KAN) Homabay (INH + GFX and INH + AMK) and Kakamega (INH + GFX). There was no polyresistant M. tuberculosis strain identified in Migori, Bungoma, Kisii, Vihiga, Busia, Siaya and Kisumu Counties. DISCUSSION The distribution patterns of M. tuberculosis drug resistance among HIV negative and positive TB patients could be as a result of reported high prevalence of HIV in Western Kenya counties especially the area under study. Tuberculosis is one of the opportunistic diseases that have been shown to be the major cause of AIDS among HIV infected patients. Resent reports by National AIDS Control Council shows that Kisumu, Siaya, Homabay, Migori, Busia have the overall leading in HIV prevalence in Kenya. The low prevalence of drug resistant strains among HIV tuberculosis patients could be as a result of drug adherence attitude adopted by HIV patients, availability of continuous counselling and close follow up and notification by healthcare workers and community health volunteers. CONCLUSION Drug resistant M. tuberculosis strains prevalence is still high among HIV negative and positive patients in Western Kenya with the most affected being HIV negative TB patients. It is therefore probable that the existing control measures are not adequate to control transmission of drug resistant strains. Further, miss diagnosis or delayed diagnosis of TB patients could be contributing to the emergence of M. tuberculosis drug polyresistant strains. RECOMMENDATION Based on the result of this study, regular TB drug resistance surveillance should be conducted to ensure targeted interventions aimed at controlling increased transmission of the tuberculosis drug resistant strains among HIV/AIDS and HIV negative patients. There is also need for improved drug resistant infection control measures, timely and rapid diagnosis and enhanced and active screening strategies of tuberculosis among suspected TB patients need to be put in place. Further, studies using a larger patient cohort and from counties across the country would shed much needed insights on the true national prevalence of different variants of M. tuberculosis drug resistance.
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Affiliation(s)
- Martin O Ogwang
- School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
| | - Mabel Imbuga
- School of Biomedical Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Caroline Ngugi
- School of Biomedical Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Lucy Mutharia
- Department of Cellular and Molecular Biology, University of Guelph, Guelph, ON, Canada
| | - Gabriel Magoma
- School of Biomedical Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Lamec Diero
- Department of Medicine, Moi University School of Medicine, Eldoret, Kenya
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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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Mohd Azmi UZ, Yusof NA, Abdullah J, Alang Ahmad SA, Mohd Faudzi FN, Ahmad Raston NH, Suraiya S, Ong PS, Krishnan D, Sahar NK. Portable electrochemical immunosensor for detection of Mycobacterium tuberculosis secreted protein CFP10-ESAT6 in clinical sputum samples. Mikrochim Acta 2021; 188:20. [PMID: 33404779 DOI: 10.1007/s00604-020-04669-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 11/24/2020] [Indexed: 01/04/2023]
Abstract
An early detection of Mycobacterium tuberculosis is very important to reduce the number of fatal cases and allow for fast recovery. However, the interpretation of the result from smear microscopy requires skilled personnel due to the propensity of the method to produce false-negative results. In this work, a portable, rapid, and simple sandwich-type immunosensor reader has been developed that is able to detect the presence of M. tuberculosis in sputum samples. By using sandwich-type immunosensor, an anti-CFP10-ESAT6 antibody was immobilized onto the graphene/polyaniline (GP/PANI)-modified gold screen-printed electrode. After incubation with the target CFP10-ESAT6 antigen, the iron/gold magnetic nanoparticles (Fe3O4/Au MNPs) conjugated with anti-CFP10-ESAT6 antibody were used to complete the sandwich format. Differential pulse voltammetry (DPV) technique was used to detect the CFP10-ESAT6 antigen at the potential range of 0.0-1.0 V. The detection time is less than 2 h. Under optimal condition, CFP10-ESAT6 antigen was detected in a linear range from 10 to 500 ng mL-1 with a limit of detection at 1.5 ng mL-1. The method developed from this process was then integrated into a portable reader. The performance of the sensor was investigated and compared with the standard methods (culture and smear microscopy). It provides a good correlation (100% sensitivity and 91.7% specificity) with both methods of detection for M. tuberculosis in sputum samples henceforth, demonstrating the potential of the device as a more practical screening tool.Graphical abstract.
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Affiliation(s)
- Umi Zulaikha Mohd Azmi
- Institute of Advanced Technology, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
| | - Nor Azah Yusof
- Institute of Advanced Technology, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
- Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia.
| | - Jaafar Abdullah
- Institute of Advanced Technology, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
- Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | - Shahrul Ainliah Alang Ahmad
- Institute of Advanced Technology, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
- Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, 43400, Serdang, Selangor, Malaysia
| | | | - Nurul Hanun Ahmad Raston
- School of Biosciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia
| | - Siti Suraiya
- School of Medical Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Poh Shing Ong
- NanoMalaysia Berhad, a CLG under the Ministry of Energy, Science, Technology, Environment and Climate Change (MESTECC), 50450, Kuala Lumpur, Malaysia
| | - Devandran Krishnan
- NanoMalaysia Berhad, a CLG under the Ministry of Energy, Science, Technology, Environment and Climate Change (MESTECC), 50450, Kuala Lumpur, Malaysia
| | - Nur Khairunnisa Sahar
- School of Medicine, Trinity Biomedical Sciences Institute, Trinity College, Dublin 2, Ireland
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10
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Ultrasensitive enzyme-linked immunosorbent assay for the detection of MPT64 secretory antigen to evaluate Mycobacterium tuberculosis viability in sputum. Int J Infect Dis 2020; 96:244-253. [PMID: 32353548 DOI: 10.1016/j.ijid.2020.04.059] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/16/2020] [Accepted: 04/18/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This study examined Mycobacterium tuberculosis (MTB)-secreted MPT64 as a surrogate of bacterial viability for the diagnosis of active pulmonary TB (PTB) and for follow-up treatment. METHODS In this proof-of-concept prospective study, 50 PTB patients in the Tokyo metropolitan region, between 2017 and 2018, were consecutively included and 30 healthy individuals were also included. Each PTB patient submitted sputum on days 0, 14 and 28 for diagnosis and follow-up, and each healthy individual submitted one sputum sample. The following were performed: smear microscopy, Xpert MTB/RIF, MGIT and solid culture, and MPT64 detection on the sputum samples. Ultrasensitive ELISA (usELISA) was used to detect MPT64. The receiver operating characteristic analyses for diagnosis and follow-up revealed the optimal cut-off value of MPT64 absorbance for detecting culture positivity at multiple intervals. RESULTS The sensitivity of MPT64 for diagnosing PTB was 88.0% (95% CI 75.7-95.5) and the specificity was 96.7% (95% CI 82.8-99.9). The specificity of MPT64 for predicting negative culture results on day 14 was 89.5% (95% CI 66.9-98.7). The sensitivity of MPT64 for predicting positive culture results on day 28 was 81.0% (95% CI 58.1-94.6). CONCLUSIONS This study revealed that MPT64 is useful for diagnosing active PTB in patients and predicting treatment efficacy at follow-up.
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11
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Kusuma SAF, Parwati I, Rostinawati T, Yusuf M, Fadhlillah M, Ahyudanari RR, Rukayadi Y, Subroto T. Optimization of culture conditions for Mpt64 synthetic gene expression in Escherichia coli BL21 (DE3) using surface response methodology. Heliyon 2019; 5:e02741. [PMID: 31844694 PMCID: PMC6895765 DOI: 10.1016/j.heliyon.2019.e02741] [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: 08/31/2019] [Revised: 10/02/2019] [Accepted: 10/24/2019] [Indexed: 12/01/2022] Open
Abstract
MPT64 is a specific protein that is secreted by Mycobacterium tuberculosis complex (MTBC). The objective of this study was to obtain optimum culture conditions for MPT64 synthetic gene expression in Escherichia coli BL21 (DE3) by response surface methodology (RSM). The RSM was undertaken to optimize the culture conditions under different cultivation conditions (medium concentration, induction time and inducer concentration), designed by the factorial Box-Bhenken using Minitab 17 statistical software. From the randomized combination, 15 treatments and three center point repetitions were obtained. Furthermore, expression methods were carried out in the flask scale fermentation in accordance with the predetermined design. Then, the MPT64 protein in the cytoplasm of E. coli cell was isolated and characterized using sodium dodecyl sulfate polyacrilamide electrophoresis (SDS-PAGE) then quantified using the ImageJ program. The optimum conditions were two-fold medium concentration (tryptone 20 mg/mL, yeast extract 10 mg/mL, and sodium chloride 20 mg/mL), 5 h of induction time and 4 mM rhamnose. The average concentration of recombinant MPT64 at optimum conditions was 0.0392 mg/mL, higher than the predicted concentration of 0.0311 mg/mL. In conclusion, the relationship between the selected optimization parameters strongly influenced the level of MPT64 gene expression in E. coli BL21 (DE3).
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Affiliation(s)
- Sri Agung Fitri Kusuma
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Sumedang, Indonesia.,Department of Biology Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Ida Parwati
- Department of Clinical Pathology, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Tina Rostinawati
- Department of Biology Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Muhammad Yusuf
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Sumedang, Indonesia.,Research Center for Molecular Biotechnology and Bioinformatics, Universitas Padjadjaran, Bandung, Indonesia
| | - Muhammad Fadhlillah
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Sumedang, Indonesia.,Research Center for Molecular Biotechnology and Bioinformatics, Universitas Padjadjaran, Bandung, Indonesia.,PT. Genpro Multiguna Sejahtera, Sumedang, Indonesia
| | - Risa R Ahyudanari
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Sumedang, Indonesia
| | - Yaya Rukayadi
- Department of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, Serdang, Malaysia
| | - Toto Subroto
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Sumedang, Indonesia.,Research Center for Molecular Biotechnology and Bioinformatics, Universitas Padjadjaran, Bandung, Indonesia
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12
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Refaya AK, Kumar N, Raj D, Veerasamy M, Balaji S, Shanmugam S, Rajendran A, Tripathy SP, Swaminathan S, Peacock SJ, Palaniyandi K. Whole-Genome Sequencing of a Mycobacterium orygis Strain Isolated from Cattle in Chennai, India. Microbiol Resour Announc 2019; 8:e01080-19. [PMID: 31582446 PMCID: PMC6776786 DOI: 10.1128/mra.01080-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 09/01/2019] [Indexed: 11/28/2022] Open
Abstract
Here, we report the isolation of Mycobacterium orygis from dairy cattle in Chennai, India. Spoligotyping assigned the isolate to spoligotype 587 (ST587), which belongs to M. orygis This species was confirmed as M. orygis using whole-genome sequencing.
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Affiliation(s)
| | - Narender Kumar
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Dhinakar Raj
- Translational Research Platform for Veterinary Biologicals (TRPVB), Tamil Nadu Veterinary and Animal Sciences University, Chennai, India
| | - Maroudam Veerasamy
- Translational Research Platform for Veterinary Biologicals (TRPVB), Tamil Nadu Veterinary and Animal Sciences University, Chennai, India
| | | | | | - Ananthi Rajendran
- ICMR-National Institute for Research in Tuberculosis, Chennai, India
| | | | | | - Sharon J Peacock
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
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13
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Watanabe Pinhata JM, Lemes RA, Simeão FCDS, Souza ARD, Chimara E, Ferrazoli L. Use of an immunochromatographic assay for rapid identification of Mycobacterium tuberculosis complex clinical isolates in routine diagnosis. J Med Microbiol 2018; 67:683-686. [PMID: 29570446 DOI: 10.1099/jmm.0.000726] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Accurate identification of Mycobacterium tuberculosis complex (MTBC) isolates is essential for tuberculosis (TB) control, especially in a high-burden country such as Brazil. Conventional identification methods are laborious and time-consuming, while rapid molecular methods are expensive and require skilled personnel and appropriate physical laboratory infrastructure. Immunochromatographic assays (ICAs) have been shown to provide a rapid and reliable TB diagnosis at a low cost. The use of the SD Bioline TB Ag MPT64 ICA (MPT64 assay) for rapid identification of MTBC clinical isolates in the routine diagnosis of a large-volume reference TB laboratory was evaluated. We analysed 375 isolates on solid and liquid media concurrently with conventional phenotypic methods, the PRA-hsp65 molecular technique and the MPT64 assay. The sensitivity, specificity and accuracy of the ICA were 97.7, 100 and 98.1 %, respectively. The MPT64 assay yielded rapid and accurate results, enabling the treatment to be initiated early and also impacting on TB control.
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Affiliation(s)
- Juliana Maira Watanabe Pinhata
- Tuberculosis and Mycobacteriosis Core, Center of Bacteriology, Adolfo Lutz Institute, Av. Dr. Arnaldo 351, CEP: 01246-902, São Paulo, SP, Brazil
| | - Romilda Aparecida Lemes
- Tuberculosis and Mycobacteriosis Core, Center of Bacteriology, Adolfo Lutz Institute, Av. Dr. Arnaldo 351, CEP: 01246-902, São Paulo, SP, Brazil
| | - Fernanda Cristina Dos Santos Simeão
- Tuberculosis and Mycobacteriosis Core, Center of Bacteriology, Adolfo Lutz Institute, Av. Dr. Arnaldo 351, CEP: 01246-902, São Paulo, SP, Brazil
| | - Andréia Rodrigues de Souza
- Tuberculosis and Mycobacteriosis Core, Center of Bacteriology, Adolfo Lutz Institute, Av. Dr. Arnaldo 351, CEP: 01246-902, São Paulo, SP, Brazil
| | - Erica Chimara
- Tuberculosis and Mycobacteriosis Core, Center of Bacteriology, Adolfo Lutz Institute, Av. Dr. Arnaldo 351, CEP: 01246-902, São Paulo, SP, Brazil
| | - Lucilaine Ferrazoli
- Tuberculosis and Mycobacteriosis Core, Center of Bacteriology, Adolfo Lutz Institute, Av. Dr. Arnaldo 351, CEP: 01246-902, São Paulo, SP, Brazil
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14
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Practice Guidelines for Clinical Microbiology Laboratories: Mycobacteria. Clin Microbiol Rev 2018; 31:31/2/e00038-17. [PMID: 29386234 DOI: 10.1128/cmr.00038-17] [Citation(s) in RCA: 152] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Mycobacteria are the causative organisms for diseases such as tuberculosis (TB), leprosy, Buruli ulcer, and pulmonary nontuberculous mycobacterial disease, to name the most important ones. In 2015, globally, almost 10 million people developed TB, and almost half a million patients suffered from its multidrug-resistant form. In 2016, a total of 9,287 new TB cases were reported in the United States. In 2015, there were 174,608 new case of leprosy worldwide. India, Brazil, and Indonesia reported the most leprosy cases. In 2015, the World Health Organization reported 2,037 new cases of Buruli ulcer, with most cases being reported in Africa. Pulmonary nontuberculous mycobacterial disease is an emerging public health challenge. The U.S. National Institutes of Health reported an increase from 20 to 47 cases/100,000 persons (or 8.2% per year) of pulmonary nontuberculous mycobacterial disease among adults aged 65 years or older throughout the United States, with 181,037 national annual cases estimated in 2014. This review describes contemporary methods for the laboratory diagnosis of mycobacterial diseases. Furthermore, the review considers the ever-changing health care delivery system and stresses the laboratory's need to adjust and embrace molecular technologies to provide shorter turnaround times and a higher quality of care for the patients who we serve.
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15
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Cai RT, Yu FX, Tao Z, Qian XQ, Chen J, Lu HZ. Routinely detected indicators in plasma have a predictive effect on the identification of HIV-infected patients with non-tuberculous mycobacterial and tuberculous infections. Infect Dis Poverty 2017; 6:132. [PMID: 29092717 PMCID: PMC5667182 DOI: 10.1186/s40249-017-0347-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 08/08/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND It is difficult to quickly distinguish non-tuberculous mycobacterial (NTM) infection from tuberculosis (TB) infection in human immunodeficiency virus (HIV)-infected patients because of many similarities between these diseases. A simple and effective way to determine the differences using routine blood tests is necessary in developing countries. METHODS A retrospective cohort study was conducted to recruit HIV-infected patients with either NTM infection or TB infection diagnosed for the first time according to mycobacterial culture and microscopic identification from May 2010 to March 2016. These data included the analysis of blood cells, liver function, renal function, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), and were compared between the HIV/TB and HIV/NTM groups. RESULTS A total of 240 patients were enrolled. The number of HIV/TB and HIV/NTM patients was 113 and 127, respectively. There were no significant differences in the CD4 T-cell count, age, sex, percentage of patients initiating antiretroviral therapy (ART) before the explicit diagnosis of TB or NTM infection. NTM infection was more likely to be restricted in the pulmonary while TB infection also involves extra-pulmonary sites. Both the leukocyte count(5.60 × 109/L) and the proportion of neutrophils in the leukocyte count (76.70%) in the HIV/TB group were significantly higher than those in the HIV/NTM group (4.40 × 109/L [P = 0.0014] and 69.30% [P < 0.001]. The analysis of liver function markers indicated that the concentration of albumin but not ALT and AST was significantly lower in the HIV/TB group than in the HIV/NTM group (P < 0.001). The creatinine and urea levels were not significantly different between the two groups. The ESR (84.00 mm/h) and the concentration of CRP (59.60 mg/L) were significantly higher in the HIV/TB group than in the HIV/NTM group (52.00 mm/h and 19.60 mg/L, respectively) (P < 0.001). To distinguish TB infection from NTM infection, the best cut-off value was 69.5 mm/h for ESR, with a positive predictive value (PPV) of 0.740 and negative predictive value (NPV) of 0.721, and 48.8 mg/L for CRP, with a PPV of 0.676 and NPV of 0.697. CONCLUSION The dissemination character as well as stronger immune response characterized by higher inflammation markers (e.g. WBC, ESR, CRP) can help distinguish TB from NTM infection in HIV-infected patients who need empirical therapy or diagnostic therapy immediately in low-income areas.
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Affiliation(s)
- Ren-Tian Cai
- Department of Infectious Diseases, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Feng-Xue Yu
- Department of Nephrology, the Second Affiliated Hospital of the Southeast University, Nanjing, China
| | - Zhen Tao
- Department of Infectious Diseases, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xue-Qin Qian
- Department of Mycobacteria Culture, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Jun Chen
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
| | - Hong-Zhou Lu
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
- Huashan Hospital affiliated to Fudan University, Shanghai, China.
- Medical College of Fudan University, Shanghai, China.
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16
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Igarashi Y, Chikamatsu K, Aono A, Yi L, Yamada H, Takaki A, Mitarai S. Laboratory evaluation of the Anyplex™ II MTB/MDR and MTB/XDR tests based on multiplex real-time PCR and melting-temperature analysis to identify Mycobacterium tuberculosis and drug resistance. Diagn Microbiol Infect Dis 2017; 89:276-281. [PMID: 28974394 DOI: 10.1016/j.diagmicrobio.2017.08.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 08/18/2017] [Accepted: 08/19/2017] [Indexed: 10/19/2022]
Abstract
We evaluated the performance of two multiplex, real-time PCR tests (Anyplex II MTB/MDR and MTB/XDR; Seegene, Seoul, Korea), designed to detect the Mycobacterium tuberculosis complex (MTC) and drug-resistance mutations associated with isoniazid, rifampicin, fluoroquinolones, and second-line injectable drugs. We analyzed 122 clinical isolates with the Anyplex II MTB/MDR test, 68 of which were also tested with the Anyplex II MTB/XDR test. The Anyplex II MTB/MDR and MTB/XDR tests showed the following respective sensitivities and specificities: 68.8% and 100% for detecting isoniazid resistance, 93.8% and 100% for rifampicin, 82.8% and 100% for levofloxacin, 75.0% and 100% for kanamycin, and 92.6% and 100% for MTC identification. These kits correctly identified 61.8% of multi-drug resistant M. tuberculosis isolates and 64.7% of extensively drug-resistant M. tuberculosis isolates, and enabled semi-automatic detection of drug-resistant MTC in 3 hours. The Anyplex II kits could be useful as rule-in tests for detecting MTC and drug resistance.
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Affiliation(s)
- Yuriko Igarashi
- Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan.
| | - Kinuyo Chikamatsu
- Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Akio Aono
- Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Lina Yi
- Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan; Department of Respiratory and Internal Medicine, Fukujuji Hospital, Tokyo, Japan; Department of Basic Mycobacteriology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Hiroyuki Yamada
- Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Akiko Takaki
- Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan
| | - Satoshi Mitarai
- Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan; Department of Basic Mycobacteriology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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17
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Getahun M, Dagne Z, Yaregal Z, Mariam AH, Moga S, Meaza A, Kebede A, Feseha Y. Conventional and Molecular Methods for the Diagnosis of Smear Negative Pulmonary TB and Concordance of Empirical TB Diagnosis with Culture Assay. ETHIOPIAN JOURNAL OF PUBLIC HEALTH AND NUTRITION 2017; 1:99-104. [PMID: 30637374 PMCID: PMC6326369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Ethiopia is among high TB burden countries. The proportion of smear negative patients among pulmonary TB cases was 51%. Nevertheless, microscopy is still a primary tool for TB diagnosis. In the absence of sensitive diagnostic methods, clinicians often make the diagnosis of smear-negative pulmonary TB with information obtained through the clinical history, physical examination and chest X-ray. The treatment of smear negative TB patients with those criteria largely depends on the treating clinician. There is limited data on the utilization of clinical criteria commonly used to initiate TB treatment empirically when culture is used as the reference method. Beside this, there are a number of sensitive diagnostic methods that have a substantial contribution for the diagnosis of smear negative TB patients, but only few studies were conducted in Ethiopia to address this issue. OBJECTIVE To assess the contribution of conventional and molecular methods for smear-negative patients and describe the concordance rate of empiric TB treatment with culture assay. METHODS A cross-sectional study was designed on smear negative TB presumptive patients referred to St. Peter's TB Specialized Hospital from December 2014 to June 2015. Consecutive smear negative TB presumptive patients, aged greater or equal to 15 and willing to participate were included in the study. Socio-demographic and clinical data were collected using the data collection form designed for the study purpose. The data collection form was designed to capture patient demographic data, signs and symptoms, chest X-ray findings and empirical TB treatment initiations. Spot-Moring-spot sputum was collected using sterile falcon tubes for routine diagnostic purpose. Direct ZN examination was done on Spot-Moring-spot sputum at St. Peter's TB Specialized Hospital. The morning sputum was used for culture (LJ and MGIT), TB-LAMP, Xpert MTB/RIF assay and fluorescent microscopy examination. Data were captured and analyzed using SPSS. RESULTS This study enrolled 459 smear negative presumptive TB patients. Most (57%) of the study participants were female; with median age of 40 IQR (28-55) years. HIV test results were available for 41% of the study participants and the prevalence of HIV among the study participants was 30%. Three hundred eighty three cases were having both treatment and lab results. Forty six cases were treated empirically. The sensitivity and specificity of empiric TB treatment when compared to culture were 45.8% and 90% respectively. The overall culture positivity rate was 6.8% (30/439), of which 6.6% (26/391) was by MGIT and 5.3% (23/436) was by LJ method. Direct and concentrated fluorescent microscopy adds 0.9% and 1.3% detection rate compared to the direct ZN. The overall sensitivity and specificity of TB-LAMP was 61.5% (16/26) and 96.6% respectively. The overall sensitivity and specificity of Xpert MTB/RIF was 70.8% (17/24) and 97.2% respectively. CONCLUSION TB-LAMP and Xpert MTB/RIFassaycan provide confirmatory results for at least two third of TB cases.
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Affiliation(s)
- Muluwork Getahun
- Ethiopian Public Health Institute, P.O. Box 1242 or 5654, Addis Ababa, Ethiopia
| | - Zekarias Dagne
- Ethiopian Public Health Institute, P.O. Box 1242 or 5654, Addis Ababa, Ethiopia
| | - Zelalem Yaregal
- Ethiopian Public Health Institute, P.O. Box 1242 or 5654, Addis Ababa, Ethiopia
| | - Aster H Mariam
- Ethiopian Public Health Institute, P.O. Box 1242 or 5654, Addis Ababa, Ethiopia
| | - Shewki Moga
- Ethiopian Public Health Institute, P.O. Box 1242 or 5654, Addis Ababa, Ethiopia
| | - Abyot Meaza
- Ethiopian Public Health Institute, P.O. Box 1242 or 5654, Addis Ababa, Ethiopia
| | - Abebaw Kebede
- Ethiopian Public Health Institute, P.O. Box 1242 or 5654, Addis Ababa, Ethiopia
| | - Yetnebersh Feseha
- Ethiopian Public Health Institute, P.O. Box 1242 or 5654, Addis Ababa, Ethiopia
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18
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Qi T, Zhang R, Shen Y, Liu L, Lowrie D, Song W, Chen J, Wang Z, Shen J, Cai R, Guan L, Luo B, Tang Y, Lu H. Etiology and clinical features of 229 cases of bloodstream infection among Chinese HIV/AIDS patients: a retrospective cross-sectional study. Eur J Clin Microbiol Infect Dis 2016; 35:1767-1770. [PMID: 27502930 DOI: 10.1007/s10096-016-2724-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 07/03/2016] [Indexed: 11/28/2022]
Abstract
Bloodstream infections (BSIs) are prevalent among people living with HIV/AIDS. The etiology varies in different regions and different periods. We aimed to survey the etiological and clinical features of BSIs in HIV patients in mainland China. We assessed all HIV patients with a positive blood culture in a Chinese teaching hospital from September 2009 through December 2014. We excluded those with specimens likely to have been contaminated. We used Pearson's chi-squared test to measure the differences in characteristics among subgroups of different pathogens. Among 2442 Chinese HIV-seropositive inpatients, 229 (9.38 %) experienced BSIs. The most common pathogens detected included Cryptococcus neoformans (22.7 %), Penicillium marneffei (18.8 %), Mycobacterium tuberculosis (15.3 %), and non-tuberculous mycobacterium (14.8 %). 30/229 (13.1 %) HIV patients with BSIs had a poor prognosis. BSIs are prevalent in hospitalized patients with HIV/AIDS in China. Fungi and mycobacteria are the predominant pathogens.
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Affiliation(s)
- T Qi
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - R Zhang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Y Shen
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - L Liu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - D Lowrie
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - W Song
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - J Chen
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Z Wang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - J Shen
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - R Cai
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - L Guan
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - B Luo
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Y Tang
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - H Lu
- Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
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19
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Saengdee P, Chaisriratanakul W, Bunjongpru W, Sripumkhai W, Srisuwan A, Hruanun C, Poyai A, Phunpae P, Pata S, Jeamsaksiri W, Kasinreak W, Promptmas C. A silicon nitride ISFET based immunosensor for Ag85B detection of tuberculosis. Analyst 2016; 141:5767-5775. [PMID: 27486595 DOI: 10.1039/c6an00568c] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
A silicon nitride Ion Sensitive Field Effect Transistor (ISFET) based immunosensor was developed as a low-cost and label-free electrical detection for the detection of antigen 85 complex B (Ag85B). The sensing membrane of the ISFET was modified with 3-aminopropyltriethoxysilane (APTES) followed by glutaraldehyde (GA), yielding an aldehyde-terminated surface. This group is available for immobilization of a monoclonal antibody against a recombinant Ag85B protein (anti-Ag85B antibody). The optimal concentration for anti-Ag85B antibody immobilization onto the modified ISFET was 100 μg ml-1. This optimal condition provided the maximal binding capability and minimal non-specific background signal. The binding event between the recombinant Ag85B antigen and anti-Ag85B antibody on the ISFET surface is presented by monitoring the gate potential change at a constant drain current. The dose response for the recombinant Ag85B protein showed a linear response between 0.12 and 1 μg ml-1 without significant interference from other recombinant proteins. The analytical imprecision (CV%) and accuracy of this Ag85B protein biosensor were 9.73-10.99% and 95.29%, respectively. In addition, an irrelevant antibody and other recombinant proteins were employed as a negative control to demonstrate the non-specific interaction of the antigen and antibody. The success of this immunosensor system for Ag85B protein detection facilitates the construction of a promising device which can shorten the turnaround time for the diagnosis of tuberculosis compared to a standard culture method. Furthermore, this device could also be applied for real-time growth monitoring of Mycobacterium tuberculosis in a mycobacterial culture system.
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Affiliation(s)
- Pawasuth Saengdee
- Department of Clinical Chemistry, Faculty of Medical Technology, Mahidol University, Nakhon Pathom 73170, Thailand
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Song W, Liu L, Lu H. [Identification of Mycobacteria isolated from AIDS patients]. Zhejiang Da Xue Xue Bao Yi Xue Ban 2016; 45:243-248. [PMID: 27677657 PMCID: PMC10397088 DOI: 10.3785/j.issn.1008-9292.2016.05.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 05/08/2016] [Indexed: 06/06/2023]
Abstract
Obstract: To identify Mycobacteria isolated from AIDS patients and to evaluate the diagnostic value of MBP64 antigen Colloidal Gold Diagnostic Kit in distinguishing Mycobacterium tuberculosis(MTB) and Nontuberculous mycobacteria (NTM). Methods: A total of 140 Mycobacteria isolates from AIDS patients were collected and identified by using 16SrDNA PCR assay as well as immune colloidal gold technique (MBP64 antigen Colloidal Gold Diagnostic Kit). The sensitivity and specificity of Colloidal Gold method was analyzed. Results: With the results of 16SrDNA PCR assay as gold standard, the sensitivity and specificity of Colloidal Gold method in distinguishing MTB and NTM were 96.00% and 96.84%, respectively. Among 140 samples, 114 were identified by 16SrDNA PCR assay, among which 50 (43.86%) were identified as MTB, and 63 (55.26%) were identified as NTM. The most popular NTM in AIDS patients were Mycobacterium gordonae, Mycobacterium avium and Mycobacterium kansasii. Conclusion: NTM is of high prevalence in AIDS patients, and MBP64 antigen Colloidal Gold Diagnostic Kit can be used as an effective technique in distinguishing NTM and MTB.
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Affiliation(s)
- Wei Song
- Department of Infectious Disease, Shanghai Public Health Clinical Center, Shanghai 201508, China
| | - Li Liu
- Department of Infectious Disease, Shanghai Public Health Clinical Center, Shanghai 201508, China
| | - Hongzhou Lu
- Department of Infectious Disease, Shanghai Public Health Clinical Center, Shanghai 201508, China;Department of Infectious Disease, Huashan Hospital, Fudan University, Shanghai 200040, China.
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Kandhakumari G, Stephen S, Sivakumar S, Narayanan S. Spoligotype patterns of Mycobacterium tuberculosis isolated from extra pulmonary tuberculosis patients in Puducherry, India. Indian J Med Microbiol 2015; 33:267-70. [PMID: 25865980 DOI: 10.4103/0255-0857.154871] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PURPOSE Genotyping studies like spoligotyping are valuable tools in understanding the genetic diversity and epidemiology of Mycobacterium tuberculosis. Though there are reports of spoligotyping of M. tuberculosis isolates from pulmonary specimens from different parts of India, spoligotyping of extra pulmonary tuberculosis isolates are very few. Puducherry has not yet recorded spoligopatterns of M. tuberculosis from either pulmonary or extra pulmonary (EPTB) specimens. The aim of this study is to analyze the spoligotype patterns of EPTB strains circulating in Puducherry and neighboring districts of Tamil Nadu. MATERIALS AND METHODS During June 2011 to December 2013, 570 EPTB specimens were processed by culturing on to Lowenstein Jensen (LJ) medium and automated Mycobacterium Growth Indicator Tube system (MGIT960). Identification of M. tuberculosis was carried out as per standard procedures, and MPT 64 antigen positivity in a commercial immunochromatography kit. Spoligotyping was carried out at National Institute of Research in Tuberculosis (ICMR), Chennai. RESULTS M. tuberculosis was isolated from 67 single EPTB specimens (11.8%) like pus/cold abscess (34), TB spine (10), pleural fluid (10), urine (5), tissue bit (2), lymph nodes (2), ascitic fluid (2), synovial fluid (1) and endometrial curetting (1). Among 67 isolates with 41 spoligopatterns, EAI lineage with 28 isolates (41.8%) predominated followed by 18 orphans (26.9%), 10 Beijing (14.9%) and 8 U (11.9%). BOVIS1_BCG (ST482), T1-T2 (ST78) and H3 (ST50) were represented by one strain each (1.5%). C onclusions: Spoligotyping plays a significant role in the epidemiology of tuberculosis. Three spoligotypes, T1-T2 (ST78), EAI6 (ST292) and U (ST1429) are reported for the first time in India.
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Affiliation(s)
| | - S Stephen
- Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, Tamil Nadu, India
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Getahun M, Ameni G, Kebede A, Yaregal Z, Hailu E, Medihn G, Demssie D, Girmachew F, Fiseha Y, Meaza A, Dirse N, Agonafir M, Dana F, Tsegaye F, Alebachew Z, Abebe A, Kebede A, Lemma E. Molecular typing and drug sensitivity testing of Mycobacterium tuberculosis isolated by a community-based survey in Ethiopia. BMC Public Health 2015; 15:751. [PMID: 26245282 PMCID: PMC4527252 DOI: 10.1186/s12889-015-2105-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Accepted: 07/28/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The identification of circulating TB strains in the community and drug sensitivity patterns is essential for the tuberculosis control program. This study was undertaken to identify M. tuberculosis strains circulating in selected communities in Ethiopia as well as to evaluate the drug sensitivity pattern of these strains. METHOD This study was a continuation of the Ethiopian National TB Prevalence Survey that was conducted between 2010 and 2011. Culture-positive isolates of M. tuberculosis from previous study were typed using region of difference (RD) 9-based polymerase chain reaction (PCR) and spoligotyping. Drug sensitivity testing was conducted using the indirect proportion method on Lowenstein-Jensen media. RESULT All 92 isolates were confirmed as M. tuberculosis by RD9-based PCR and spoligotyping of 91 of these isolates leds to the identification of 41 spoligotype patterns. Spoligotype revealed higher diversity (45 %) and among this 65.8 % (27/41) were not previously reported. The strains were grouped into 14 clusters consisting of 2-15 isolates. The dominant strains were SIT53, SIT149 and SIT37 consisting of 15, 11, and 9 isolates, respectively. Our study reveals 70 % (64/91) clustered strains and only 39.1 % (25/64) occurred within the same Kebele. Further assignment of the strains to the lineages showed that 74.7 % (68/91) belonged to Euro-American lineage, 18.6 % (17/91) to East Africa Indian lineage and the remaining 6.5 % (6/91) belonged to Indo-oceanic lineage. Valid drug susceptibility test results were available for 90 of the 92 isolates. Mono-resistance was observed in 27.7 % (25/90) and poly-resistance in 5.5 % (5/90) of the isolates. Moreover, multi-drug resistance (MDR-TB) was detected in 4.4 % of the isolates whilst the rest (60/90) were susceptible to all drugs. The highest level of mono-resistance, 26.6 % (24/90), was observed for streptomycin with majority (91.1 %) of streptomycin mono-resistant strains belonging to the Euro-American lineage. CONCLUSION In this study, the strains of M. tuberculosis circulating in selected sites of Ethiopia were identified along with the drug sensitivity patterns. Thus, these findings are useful for the TB Control Program of the country.
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Affiliation(s)
| | - Gobena Ameni
- Aklilu Lema Institute of Pathobiology, Addis Ababa, Ethiopia.
| | - Abebaw Kebede
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | | | - Elena Hailu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
| | - Grimay Medihn
- Aklilu Lema Institute of Pathobiology, Addis Ababa, Ethiopia.
| | - Daniel Demssie
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | | | | | - Abyot Meaza
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Nathneal Dirse
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | | | - Feleke Dana
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Fasil Tsegaye
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | | | - Almaz Abebe
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Amha Kebede
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | - Eshetu Lemma
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
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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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Arora J, Kumar G, Verma AK, Bhalla M, Sarin R, Myneedu VP. Utility of MPT64 Antigen Detection for Rapid Confirmation of Mycobacterium tuberculosis Complex. J Glob Infect Dis 2015; 7:66-9. [PMID: 26069425 PMCID: PMC4448327 DOI: 10.4103/0974-777x.154443] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Rapid differentiation of the Mycobacterium tuberculosis complex (MTBC) and mycobacteria other than tuberculosis (MOTT) is crucial to facilitate early and effective treatment of the patients. Clinical presentation of MTBC and MOTT is not always very clear and routine conventional methods are time consuming. Materials and Methods: In the present study, the MPT64 protein detection-based immunochomatographic test (SD Bioline Kit, Standard Diagnostics, Inc., Korea) was compared with the conventional biochemical method. Results: The sensitivity, specificity, positive predictive, and negative predictive values of the SD AgMPT64 kit were found to be 100, 96.4, 98.72, and 100%, respectively. Conclusions: Our results have demonstrated that the SD bioline kit is a rapid, reliable method and it can be used in the Revised National Tuberculosis Control Program (RNTCP) of India, for the appropriate management of tuberculosis.
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Affiliation(s)
- Jyoti Arora
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, India
| | - Gavish Kumar
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, India
| | - Ajoy Kumar Verma
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, India
| | - Manpreet Bhalla
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, India
| | - Rohit Sarin
- Department of TB and Chest, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, India
| | - Vithal Prasad Myneedu
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi, India
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Qiu Y, Wan L, Liu H, Wan K, Guan C, Jiang Y. Impact of 63-bp deletion and single-base mutation in mpt64 gene on M.tb diagnosis. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:3210-3214. [PMID: 26045842 PMCID: PMC4440151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 02/20/2015] [Indexed: 06/04/2023]
Abstract
After previous research, which selected 180 clinical isolates of the Mycobacterium tuberculosis complex (MTC) from patients in China and performed comparative sequence analysis of the mpt64 gene after amplification and found the polymorphisms of the mpt64 gene in MTC, in order to further investigate the impact of polymorphism of antigen MPT64 on the diagnostic accuracy of MPT64-based test kit, testing on 180 strains by MPT64-based immunochromatographic test (ICT) was conducted. As a result, 180 strains were detected positive except 8 isolates were negative. First, 8 strains harbored 63-bp deletion had a major impact on the biological function of mpt64 and led to the negative results; however, 4 isolates had nonsynonymous nucleotide mutation which led to rare changes in protein structure, did not led to functional change as those 4 strains detected positive by ICT; one strain with a single-base insertion, as the insertion occurred in the last amino acid codon that did not affect T-cell epitopes in MPT64, detected positive by this method. These demonstrate that different mutations in mpt64 gene had impact on diagnostic test kit inconsistently, this was different with some previous studies. And the performance of the mpt64-based diagnostic test kit was still very well with a sensitivity of 95.6% (172/180).
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Affiliation(s)
- Yan Qiu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and PreventionBeijing 102206, P. R. China
| | - Li Wan
- Department of Physiology, Xiangya School of Medicine, Central South UniversityChangsha, Hunan 410078, China
| | - Haican Liu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and PreventionBeijing 102206, P. R. China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesHangzhou 310003, China
| | - Kanglin Wan
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and PreventionBeijing 102206, P. R. China
- Collaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesHangzhou 310003, China
| | - Chaxiang Guan
- Department of Physiology, Xiangya School of Medicine, Central South UniversityChangsha, Hunan 410078, China
| | - Yi Jiang
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and PreventionBeijing 102206, P. R. China
- Department of Physiology, Xiangya School of Medicine, Central South UniversityChangsha, Hunan 410078, China
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Kandhakumari G, Stephen S. Extra pulmonary tuberculosis: rapid identification of Mycobacterium tuberculosis grown in Mycobacterium growth indicator tube 960 and Lowenstein-Jensen media, employing Standard diagnostics Bioline Mycobacterium tuberculosis protein 64 antigen detection kit. Indian J Med Microbiol 2015; 33 Suppl:122-5. [PMID: 25657129 DOI: 10.4103/0255-0857.150912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Investigation of extra pulmonary tuberculosis (EPTB) in and around Pondicherry is being carried out since August 2011 in our tertiary care super specialty hospital. OBJECTIVES To compare the rapid Kit SD Bio-Line MPT 64 Ag with conventional and time consuming biochemical tests. Confirmation of Mycobacterium tuberculosis at a reasonable time frame is the main thrust. MATERIALS AND METHODS Thirty three Mycobacterium tuberculosis and four Non-Tuberculous Mycobacteria (NTM) grown in MGIT960 system/Lowenstein-Jensen media (LJ) were examined by the rapid MPT 64 antigen detection as well as a battery of conventional tests like niacin, nitrate reduction, paraminobenzoic acid susceptibility and cord formation. RESULTS AND CONCLUSION . Both the rapid kit and conventional tests correctly identified 33 M.tuberculosis isolates. Keeping conventional identification as reference, sensitivity and specificity for rapid kit was 100%. Rapid kit which takes only 15 minutes is accurate, cost effective, and facilitates early treatment for these EPTB patients, whose clinical specimens are paucibacillary.
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Affiliation(s)
| | - S Stephen
- Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Pondicherry-607 402, India
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Byeon HS, Ji MJ, Kang SS, Kim SW, Kim SC, Park SY, Kim G, Kim J, Cho JE, Ku BK, Kim JM, Jeon BY. Performance of the SD Bioline TB Ag MPT64 Rapid test for quick confirmation of Mycobacterium bovis isolates from animals. J Vet Sci 2014; 16:31-5. [PMID: 25269718 PMCID: PMC4367147 DOI: 10.4142/jvs.2015.16.1.31] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 09/27/2014] [Indexed: 12/02/2022] Open
Abstract
Mycobacterium (M.) bovis, a bacterium in the M. tuberculosis complex, is a causative agent of bovine tuberculosis, a contagious disease of animals. Mycobacterial culture is the gold standard for diagnosing bovine tuberculosis, but this technique is laborious and time-consuming. In the present study, performance of the SD Bioline TB Ag MPT4 Rapid test, an immunochromatographic assay, was evaluated using reference bacterial strains and M. bovis field isolates collected from animals. The SD MPT64 Rapid test produced positive results for 95.5% (63/66) of the M. bovis isolates from cattle and 97.9% (46/47) of the isolates from deer. Additionally, the test had a sensitivity of 96.5% (95% CI, 91.2-99.0), specificity of 100% (95% CI, 96.7-100.0), positive predictive value of 100% (95% CI, 96.7-100.0), and negative predictive value of 92.9% (95% CI, 82.7-98.0) for M. bovis isolates. In conclusion, the SD MPT64 Rapid test is simple to use and may be useful for quickly confirming the presence of M. bovis in animals.
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Abouyannis M, Dacombe R, Dambe I, Mpunga J, Faragher B, Gausi F, Ndhlovu H, Kachiza C, Suarez P, Mundy C, Banda HT, Nyasulu I, Squire SB. Drug resistance of Mycobacterium tuberculosis in Malawi: a cross-sectional survey. Bull World Health Organ 2014; 92:798-806. [PMID: 25378741 PMCID: PMC4221759 DOI: 10.2471/blt.13.126532] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 07/31/2014] [Accepted: 08/07/2014] [Indexed: 11/29/2022] Open
Abstract
Objective To document the prevalence of multidrug resistance among people newly diagnosed with – and those retreated for – tuberculosis in Malawi. Methods We conducted a nationally representative survey of people with sputum-smear-positive tuberculosis between 2010 and 2011. For all consenting participants, we collected demographic and clinical data, two sputum samples and tested for human immunodeficiency virus (HIV).The samples underwent resistance testing at the Central Reference Laboratory in Lilongwe, Malawi. All Mycobacterium tuberculosis isolates found to be multidrug-resistant were retested for resistance to first-line drugs – and tested for resistance to second-line drugs – at a Supranational Tuberculosis Reference Laboratory in South Africa. Findings Overall, M. tuberculosis was isolated from 1777 (83.8%) of the 2120 smear-positive tuberculosis patients. Multidrug resistance was identified in five (0.4%) of 1196 isolates from new cases and 28 (4.8%) of 581 isolates from people undergoing retreatment. Of the 31 isolates from retreatment cases who had previously failed treatment, nine (29.0%) showed multidrug resistance. Although resistance to second-line drugs was found, no cases of extensive drug-resistant tuberculosis were detected. HIV testing of people from whom M. tuberculosis isolates were obtained showed that 577 (48.2%) of people newly diagnosed and 386 (66.4%) of people undergoing retreatment were positive. Conclusion The prevalence of multidrug resistance among people with smear-positive tuberculosis was low for sub-Saharan Africa – probably reflecting the strength of Malawi’s tuberculosis control programme. The relatively high prevalence of such resistance observed among those with previous treatment failure may highlight a need for a change in the national policy for retreating this subgroup of people with tuberculosis.
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Affiliation(s)
- Michael Abouyannis
- Centre for Applied Health Research & Delivery, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, England
| | - Russell Dacombe
- Centre for Applied Health Research & Delivery, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, England
| | - Isaias Dambe
- National Tuberculosis Control Programme, Lilongwe, Malawi
| | - James Mpunga
- National Tuberculosis Control Programme, Lilongwe, Malawi
| | - Brian Faragher
- Centre for Applied Health Research & Delivery, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, England
| | - Francis Gausi
- National Tuberculosis Control Programme, Lilongwe, Malawi
| | - Henry Ndhlovu
- Research for Equity and Community Health Trust, Lilongwe, Malawi
| | - Chifundo Kachiza
- Tuberculosis Control Assistance Programme, Management Sciences for Health, Lilongwe, Malawi
| | - Pedro Suarez
- Management Sciences for Health, Arlington, United States of America
| | - Catherine Mundy
- Management Sciences for Health, Arlington, United States of America
| | - Hastings T Banda
- Research for Equity and Community Health Trust, Lilongwe, Malawi
| | | | - S Bertel Squire
- Centre for Applied Health Research & Delivery, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, England
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Yeh CH, Zhao ZQ, Shen PL, Lin YC. Optimization of an optical inspection system based on the Taguchi method for quantitative analysis of point-of-care testing. SENSORS 2014; 14:16148-58. [PMID: 25256108 PMCID: PMC4208167 DOI: 10.3390/s140916148] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 08/18/2014] [Accepted: 08/25/2014] [Indexed: 11/23/2022]
Abstract
This study presents an optical inspection system for detecting a commercial point-of-care testing product and a new detection model covering from qualitative to quantitative analysis. Human chorionic gonadotropin (hCG) strips (cut-off value of the hCG commercial product is 25 mIU/mL) were the detection target in our study. We used a complementary metal-oxide semiconductor (CMOS) sensor to detect the colors of the test line and control line in the specific strips and to reduce the observation errors by the naked eye. To achieve better linearity between the grayscale and the concentration, and to decrease the standard deviation (increase the signal to noise ratio, S/N), the Taguchi method was used to find the optimal parameters for the optical inspection system. The pregnancy test used the principles of the lateral flow immunoassay, and the colors of the test and control line were caused by the gold nanoparticles. Because of the sandwich immunoassay model, the color of the gold nanoparticles in the test line was darkened by increasing the hCG concentration. As the results reveal, the S/N increased from 43.48 dB to 53.38 dB, and the hCG concentration detection increased from 6.25 to 50 mIU/mL with a standard deviation of less than 10%. With the optimal parameters to decrease the detection limit and to increase the linearity determined by the Taguchi method, the optical inspection system can be applied to various commercial rapid tests for the detection of ketamine, troponin I, and fatty acid binding protein (FABP).
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Affiliation(s)
- Chia-Hsien Yeh
- Department of Engineering Science, National Cheng Kung University, Tainan 701, Taiwan.
| | - Zi-Qi Zhao
- Department of Engineering Science, National Cheng Kung University, Tainan 701, Taiwan.
| | - Pi-Lan Shen
- Firstep Bioresearch, Incorporation, Tainan 701, Taiwan.
| | - Yu-Cheng Lin
- Department of Engineering Science, National Cheng Kung University, Tainan 701, Taiwan.
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Shenoy VP, Mukhopadhyay C. Rapid Immunochromatographic Test for the Identification and Discrimination of Mycobacterium tuberculosis Complex Isolates from Non-tuberculous Mycobacteria. J Clin Diagn Res 2014; 8:DC13-5. [PMID: 24959442 DOI: 10.7860/jcdr/2014/7098.4253] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 02/15/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND A new rapid Immunochromatographic test (ICT) kit (SDBioline TB Ag MPT64RAPID(®)) developed by Standard Diagnostics, South Korea was evaluated for rapid differentiation of M. tuberculosis from non tuberculous mycobacteria (NTM). It detects MPT 64 antigen in M. tuberculosis isolates using mouse monoclonal MPT 64 antibody. The kit was assessed for routine identification of the Acid Fast Bacilli(AFB) isolated in our laboratory. MATERIALS AND METHODS Two hundred eight culture isolates of Mycobacteria were tested using ICT test kit for detection of MPT 64 antigen from liquid and solid culture. H37Rv strain was employed as the positive reference control. Any negative result was referred for confirmation by Gen Probe Accu Probe assay for MTB Complex (Gen-Probe, San Diego, Calif.). Speciation of NTM was performed using genotypic Mycobacterium CM assay (Hain's life sciences, Germany). RESULTS Of the 208 culture positive isolates tested, 182 (87.5%) were found positive for Mycobacterium tuberculosis Complex and remaining 26 (12.5%) were considered as NTM. These results were further confirmed by Gen Probe Accu probe assay that served as the reference method for detection of MTBC. H37Rv reference strain was taken as a control for ICT test and molecular tests. The reference strain showed the presence of MPT64 antigen band in the ICT test. Similar bands were formed in all MTBC (182) isolates tested, proving 100 per cent sensitivity and no bands were detected in 48 (100%) NTM isolates tested, proving 100 per cent specificity of the ICT kit. CONCLUSION Tuberculosis is a global pandemic. Rapid identification of Mycobacteria as MTB complex or non-tuberculous Mycobacteria from culture is important for treatment of infected cases and drug susceptibility testing of the culture isolate. MPT 64 TB antgen detection using SD Bioline Immunochromatographic test is a simple and cost effective method for differentiation of Mycobacterial cultures as MTB complex from non- tuberculous Mycobacteria.
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Affiliation(s)
- Vishnu Prasad Shenoy
- Associate Professor, Department of Microbiology, Kasturba Medical College Manipal, Karnataka, India
| | - Chiranjay Mukhopadhyay
- Professor and Head, Department of Microbiology, Kasturba Medical College Manipal, Karnataka, India
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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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Kumar P, Benny P, Jain M, Singh S. Comparison of an in-house multiplex PCR with two commercial immuno-chromatographic tests for rapid identification and differentiation of MTB from NTM isolates. Int J Mycobacteriol 2014; 3:50-6. [PMID: 26786223 DOI: 10.1016/j.ijmyco.2013.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 12/17/2013] [Accepted: 12/18/2013] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Species specific diagnosis of mycobacterial infection is crucial because treatment of infections caused by Mycobacterium tuberculosis (MTB) differs from that of non-tuberculous mycobacterial (NTM) species. The species identification used to be cumbersome and non-reproducible a decade ago. OBJECTIVES Recently, some commercial tests have been made available to differentiate the MTB and NTM growths in culture media. Sensitivity and specificity of these tests was evaluated. MATERIALS AND METHODS In this double blind study 572 clinical samples were cultured in an automated BACTEC-MGIT-960 system. A total of 147 (25.7%) samples were MGIT culture positive. These cultures were subjected to an in-house m-PCR (which amplifies hsp-65, esat-6 and ITS region for MAC), two commercial immune-chromatographic tests (ICTs) and phenotypic tests. RESULTS Of the 147 MGIT positive cultures, m-PCR was able to correctly identify MTB in 123 cultures and NTM in 24 which included 3 MAC isolates. m-PCR showed 100% agreement with two gold standard methods-the nitrate reductase assay and PNB tests-in correctly identifying MTB. Commercial strips were able to correctly identify MTB in 120 (97.5%) of 123 cultures, while 3 (2.5%) isolates were falsely identified as NTM. However, none of the growth negative spent medium gave false positive results in any of the tests. None of the commercial strips misidentified any of the 24 NTM as MTB; hence, specificity of these strips was 100%. Of the 2 IC test systems, both SD Bioline and BD TBc strip tests missed 2.5% of MTB isolates and misidentified these as NTM. CONCLUSION The in-house m-PCR was found to be the most accurate and efficient tool for identifying the MTB, MAC and other NTMs.
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Affiliation(s)
- Parveen Kumar
- Division of Clinical Microbiology & Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Prit Benny
- Division of Clinical Microbiology & Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Manisha Jain
- Division of Clinical Microbiology & Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Sarman Singh
- Division of Clinical Microbiology & Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
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Dynamic evolution and immunoreactivity of aptamers binding to polyclonal antibodies against MPT64 antigen of Mycobacterium tuberculosis. Eur J Clin Microbiol Infect Dis 2014; 33:1199-209. [PMID: 24500599 DOI: 10.1007/s10096-014-2056-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 01/07/2014] [Indexed: 02/07/2023]
Abstract
Antibody responses can be useful markers of tuberculosis infection. However, the established immunoassay diagnostic method is limited by antigenic variability. Replacing the recombinant proteins with aptamers may overcome these antigenic challenges. In this study, we systematically monitored the selection process of aptamers against anti-MPT64 antibodies of Mycobacterium tuberculosis to obtain more aptamers for developing a multisite system to increase the sensitivity of TB serological diagnosis. Twelve high-affinity aptamers with distinctive secondary structures were obtained by analyzing the dynamic evolution of aptamers against anti-MPT64 antibodies in the process of system evolution of ligands by exponential enrichment (SELEX). Pocket and stem-loops were found to be the basis of these aptamers binding to antibodies. Point mutations of highly conserved nucleotides in the pocket and stem-loop structures resulted in decreased affinity of aptamers to targets. To test the potential of these aptamers for future use in a serological diagnostic tool, three high-affinity aptamers with different epitope specificities were applied as capture aptamer in an enzyme-linked immunosorbent assay (ELISA) with sera of TB patients. The results showed that three aptamers all effectively bound anti-MPT64 antibodies from TB patients and had high specificity and sensitivity. These aptamers with high immunoreactivity in human sera may represent an efficient and promising analogue of MPT64 and have potential to substitute MPT64 as a nucleic acid antigen in the serological diagnosis of TB. Moreover, these aptamers with different epitope specificities may facilitate the development of a sandwich assay platform or a multisite system to effectively capture more targets in sera.
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Chikamatsu K, Aono A, Yamada H, Sugamoto T, Kato T, Kazumi Y, Tamai K, Yanagisawa H, Mitarai S. Comparative evaluation of three immunochromatographic identification tests for culture confirmation of Mycobacterium tuberculosis complex. BMC Infect Dis 2014; 14:54. [PMID: 24484470 PMCID: PMC3916065 DOI: 10.1186/1471-2334-14-54] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 01/27/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rapid identification of acid-fast bacilli recovered from patient specimens as Mycobacterium tuberculosis complex (MTC) is critically important for accurate diagnosis and treatment. A thin-layer immunochromatographic (TLC) assay using anti-MPB64 or anti-MPT64 monoclonal antibodies was developed to discriminate between MTC and non-tuberculosis mycobacteria (NTM). Capilia TB-Neo, which is the improved version of Capilia TB, is recently developed and needs to be evaluated. METHODS Capilia TB-Neo was evaluated by using reference strains including 96 Mycobacterium species (4 MTC and 92 NTM) and 3 other bacterial genera, and clinical isolates (500 MTC and 90 NTM isolates). M. tuberculosis isolates tested negative by Capilia TB-Neo were sequenced for mpt64 gene. RESULTS Capilia TB-Neo showed 100% agreement to a subset of reference strains. Non-specific reaction to M. marinum was not observed. The sensitivity and specificity of Capilia TB-Neo to the clinical isolates were 99.4% (99.6% for M. tuberculosis, excluding M. bovis BCG) for clinical MTC isolates and 100% for NTM isolates tested, respectively. Two M. tuberculosis isolates tested negative by Capilia TB-Neo: one harbored a 63-bp deletion in the mpt64 gene and the other possessed a 3,659-bp deletion from Rv1977 to Rv1981c, a region including the entire mpt64 gene. CONCLUSIONS Capilia TB-Neo is a simple, rapid and highly sensitive test for identifying MTC, and showed better specificity than Capilia TB. However, Capilia TB-Neo still showed false-negative results with mpt64 mutations. The limitation should be recognized for clinical use.
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Affiliation(s)
- Kinuyo Chikamatsu
- Department of Mycobacterium Reference and Research, Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose, Tokyo 204-8533, Japan.
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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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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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Munoz-Davila MJ, Tápia EL, Díaz IS, García MAC, Martinez-Lirola MJ. Selecting criteria for improving results of an immunochromatographic assay for Mycobacterium tuberculosis complex identification from BacT/ALERT cultures. J Microbiol Methods 2013; 94:232-4. [DOI: 10.1016/j.mimet.2013.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 06/19/2013] [Accepted: 06/20/2013] [Indexed: 12/27/2022]
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Muddaiah RK, James PM, Lingegowda RK. Comparative study of Smear Microscopy, Rapid Slide Culture, and Lowenstein - Jensen culture in cases of pulmonary tuberculosis in a tertiary care hospital. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2013; 18:767-71. [PMID: 24381619 PMCID: PMC3872584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 03/28/2013] [Accepted: 06/02/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Tuberculosis (TB), a dreadful disease known to mankind continues to be a problem in a developing country like India. The incidence of people getting infected with TB is on the rise due to compounding factors like coinfection with the human immunodefiency virus and multidrug-resistant strains. There is a definitive need for early diagnosis and treatment of TB to curb transmission of the infection. Direct smear microscopy, though cheap and rapid, lacks sensitivity. Isolation of Mycobacterium tuberculosis in culture requires a long time, because of which there is a need for a rapid method which has good sensitivity and specificity for the detection of M. tuberculosis. The present study was undertaken to determine the test which diagnoses TB rapidly and to compare the sensitivity of smear microscopy, concentration method, rapid slide culture, and Lowenstein - Jensen (LJ) culture. MATERIALS AND METHODS Sputum samples of 200 patients were subjected to direct smear and concentration by modified Petroff's method. The concentrated sputum was also taken for slide culture using human blood medium and inoculated on LJ media. RESULTS LJ culture was positive in 47 (23.5%) cases, of which three were nontubercular mycobacteria. Using LJ culture as the standard method, the sensitivity of direct smear, concentration method, and rapid slide culture method was 68, 83, and 89%, respectively, and specificity was 100% in all the three tests. CONCLUSION Rapid slide culture showed good sensitivity which was comparable to and next in efficacy to LJ culture and this technique can be adopted in the Revised National Tuberculosis Control Program (RNTCP) as it is a rapid, cheap, sensitive, and specific method.
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Affiliation(s)
- Ravish Kumar Muddaiah
- Department of Microbiology, Basaveshwara Medical college, Chitradurga, India,Address for correspondence: Dr. Ravish Kumar M, Department of Microbiology, Basaveshwara Medical College, Chitradurga - 577 501, India. E-mail:
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Tuberculosis diagnosis using immunodominant, secreted antigens of Mycobacterium tuberculosis. Tuberculosis (Edinb) 2013; 93:381-8. [PMID: 23602700 DOI: 10.1016/j.tube.2013.03.003] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 03/11/2013] [Accepted: 03/23/2013] [Indexed: 12/19/2022]
Abstract
Tuberculosis (TB) remains a major public health concern in most low-income countries. Hence, rapid and sensitive TB diagnostics play an important role in detecting and preventing the disease. In addition to established diagnostic methods, several new approaches have been reported. Some techniques are simple but time-consuming, while others require complex instrumentation. One prominent and readily available approach is to detect proteins that Mycobacterium tuberculosis secretes, such as Mpt64, the 6-kDa early secreted antigenic target (Esat6), the 10-kDa culture filtrate protein (Cfp10), and the antigen 85 (Ag85) complex. Although their functions are not fully understood, a growing body of molecular evidence implicates them in M. tuberculosis virulence. Currently these biomarkers are either being used or investigated for use in skin patch tests, biosensor analyses, and immunochromatographic, immunohistochemical, polymerase chain reaction-based, and enzyme-linked immunosorbent assays. This review provides a comprehensive discussion of the roles these immunodominant antigens play in M. tuberculosis pathogenesis and compares diagnostic methods based on the detection of these proteins with more established tests for TB.
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40
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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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Pokam BT, Asuquo AE, Goh KS, Abia-Bassey LN, Rastogi N. Utility and diagnostic performance of Mycobacterium tuberculosis complex by two immunochromatographic assays as compared with the molecular Genotype assay in Nigeria. Int J Mycobacteriol 2013; 2:34-7. [PMID: 26785786 DOI: 10.1016/j.ijmyco.2012.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Accepted: 12/16/2012] [Indexed: 12/01/2022] Open
Abstract
Among the disadvantages of smear microscopy for detection of tuberculosis cases is its inability to differentiate between Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacteria (NTM). This study evaluated two, new immunochromatographic assays - Capilia TB-Neo and SD Bioline - on unheated and heated cultures at 80°C for 30min respectively for their ability to discriminate between MTB complex and NTM as compared with the molecular Genotype assay. Mycobacteria used in the study were obtained from smear-positive specimens collected from patients at four major hospitals in Cross River State, Nigeria. Capilia TB-Neo and SD Bioline showed sensitivities of 98.8% and 93.8% respectively and 100% specificity for both assays. Heating the isolates did not significantly impact the test performance. Both tests are recommended for use in rapid differentiation of strains isolated in Nigeria.
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Affiliation(s)
- Benjamin Thumamo Pokam
- Department of Medical Laboratory Science, Faculty of Health Sciences, University of Buea, Cameroon.
| | - Anne E Asuquo
- Department of Medical Laboratory Science, College of Medical Sciences, University of Calabar, Nigeria
| | - Khye Seng Goh
- WHO Supranational TB Reference Laboratory, TB & Mycobacteria Unit, Institut Pasteur de la Guadeloupe, 97183 Abymes, Guadeloupe, France
| | - Lydia N Abia-Bassey
- Department of Medical Laboratory Science, College of Medical Sciences, University of Calabar, Nigeria
| | - Nalin Rastogi
- WHO Supranational TB Reference Laboratory, TB & Mycobacteria Unit, Institut Pasteur de la Guadeloupe, 97183 Abymes, Guadeloupe, France
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Roberts SA, Lowe O, Pandey S, Williamson DA, Newton S, Vaughan R. Comparison of the MGIT TBc immunochromatographic assay with the Accuprobe Gen-Probe TB assay for identification of Mycobacterium tuberculosis complex: results from a low-burden tuberculosis setting. Diagn Microbiol Infect Dis 2012; 74:415-6. [PMID: 23036825 DOI: 10.1016/j.diagmicrobio.2012.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 07/31/2012] [Accepted: 08/06/2012] [Indexed: 11/25/2022]
Abstract
We compared the BD MPT64 TBc Antigen assay with the Gen-Probe TB assay for identifying Mycobacterium tuberculosis (MTB) from liquid culture vials. The BD TBc Antigen assay was more sensitive than and as specific as the Gen-Probe TB assay, making it a useful alternative for the rapid detection of MTB.
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Affiliation(s)
- Sally A Roberts
- Mycobacteria Section, Department of Microbiology, Auckland District Health Board, Auckland New Zealand.
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Vadwai V, Sadani M, Sable R, Chavan A, Balan K, Naik A, Kambli P, Dhane V, Patankar M, Shetty A, Rodrigues C. Immunochromatographic assays for detection of Mycobacterium tuberculosis: what is the perfect time to test? Diagn Microbiol Infect Dis 2012; 74:282-7. [PMID: 22867729 DOI: 10.1016/j.diagmicrobio.2012.06.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 06/21/2012] [Accepted: 06/25/2012] [Indexed: 11/30/2022]
Abstract
In this study, we aimed to correlate the analytical performance of SD BIOLINE TB Ag MPT64 Rapid Test kit (MPT64 assay) with the mycobacterial growth unit (GU) reported by the BACTEC MGIT 960 (MGIT 960) instrument. A total of 394 culture isolates reported positive by MGIT 960 were processed daily (until 'day 4') with the MPT64 assay until a positive MPT64 result was obtained and their GU values were noted daily before MPT64 testing. Based on this correlation of MPT64 positivity and corresponding GU values, a GU cut-off was determined. In the validation phase, with the experimentally determined GU cut-off value, 99.1% (576/581) of culture isolates were correctly identified as MTB within 2 days from instrument positivity. All results were available using a single-MPT64 assay strip, making the assay cost-effective. Thus, systematic implementation of the MPT64 assay proved to be cost-effective in a high-throughput laboratory without any delay in patient reporting.
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Affiliation(s)
- Viral Vadwai
- P. D. Hinduja National Hospital and Medical Research Centre, Microbiology Department, S1 Building, 5th Floor, Veer Savarkar Marg, Mahim, Mumbai 400016, Maharashtra, India
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Guo A, Sheng H, Zhang M, Wu R, Xie J. Development and Evaluation of a Colloidal Gold Immunochromatography Strip for Rapid Detection ofVibrio parahaemolyticusin Food. J FOOD QUALITY 2012. [DOI: 10.1111/j.1745-4557.2012.00449.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Ailing Guo
- College of Food Science & Technology; Huazhong Agricultural University; 1 Shizi Shan Street; Wuhan; 430070; Hubei; China
| | - Hongli Sheng
- College of Food Science & Technology; Huazhong Agricultural University; 1 Shizi Shan Street; Wuhan; 430070; Hubei; China
| | - Min Zhang
- College of Food Science & Technology; Huazhong Agricultural University; 1 Shizi Shan Street; Wuhan; 430070; Hubei; China
| | - Renwei Wu
- College of Food Science & Technology; Huazhong Agricultural University; 1 Shizi Shan Street; Wuhan; 430070; Hubei; China
| | - Ji Xie
- College of Food Science & Technology; Huazhong Agricultural University; 1 Shizi Shan Street; Wuhan; 430070; Hubei; China
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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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Toihir AHOS, Rasolofo V, Andrianarisoa SH, Ranjalahy GM, Ramarokoto H. Validation of an immunochromatographic assay kit for the identification of the Mycobacterium tuberculosis complex. Mem Inst Oswaldo Cruz 2012; 106:777-80. [PMID: 22012237 DOI: 10.1590/s0074-02762011000600022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Accepted: 07/22/2011] [Indexed: 11/22/2022] Open
Abstract
The performance of the immunochromatographic assay, SD BIOLINE TB Ag MPT64 RAPID®, was evaluated in Madagascar. Using mouse anti-MPT64 monoclonal antibodies for rapid discrimination between the Mycobacterium tuberculosis complex and nontuberculous mycobacteria, the kit was tested on mycobacteria and other pathogens using conventional methods as the gold standard. The results presented here indicate that this kit has excellent sensitivity (100%) and specificity (100%) compared to standard biochemical detection and can be easily used for the rapid identification of M. tuberculosis complex.
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47
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Clinical Value of ELISA-MPT64 for the Diagnosis of Tuberculous Pleurisy. Curr Microbiol 2012; 65:313-8. [DOI: 10.1007/s00284-012-0157-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2012] [Accepted: 05/17/2012] [Indexed: 10/28/2022]
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Maurya AK, Nag VL, Kant S, Kushwaha RAS, Kumar M, Mishra V, Rahman W, Dhole TN. Evaluation of an immunochromatographic test for discrimination between Mycobacterium tuberculosis complex & non tuberculous mycobacteria in clinical isolates from extra-pulmonary tuberculosis. Indian J Med Res 2012; 135:901-6. [PMID: 22825610 PMCID: PMC3410218] [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: 11/29/2022] Open
Abstract
BACKGROUND & OBJECTIVES Accurate diagnosis of tuberculosis (TB) is crucial to facilitate early treatment of the patients, and to reduce its spread. Clinical presentation of Mycobacterium tuberculosis complex (MTBC) and non tuberculous mycobacteria (NTM) may or may not be the same, but the treatment regimen is always different for both the infections. Differentiation between MTBC and NTM by routine laboratory methods is time consuming and cumbersome. This study was aimed to evaluate an immunochromatographic test (ICT), based on mouse monoclonal anti-MPT64, for simple and rapid discrimination between MTBC and NTM in clinical isolates from extra-pulmonary tuberculosis cases. METHODS A total of 800 clinical samples were collected from patients suspected to have extra-pulmonary tuberculosis. Preliminary diagnosis has been done by direct Ziehl-Neelsen (ZN) staining followed by culture in BACTEC system. A total of 150 clinical isolates, which were found positive in BD 460 TB system during September 2009 to September 2010 were selected for the screening by ICT test. p-nitro-α-acetylamino- β-hydroxy propiophenone (NAP) test was performed for differentiation of MTBC and NTM. M. tuberculosis complex was further confirmed by IS6110 PCR of BACTEC culture positive isolates, this served as the reference method for MTBC identification and comparative evaluation of the ICT kit. RESULTS Of the 150 BACTEC culture positive isolates tested by ICT kit, 101 (67.3%) were found positive for MTBC and remaining 49 (32.7%) were considered as NTM. These results were further confirmed by IS6110 PCR that served as the reference method for detection of MTBC. H 37 Rv reference strain was taken as a control for ICT test and IS6110 PCR. The reference strain showed the presence of MPT64 antigen band in the ICT test. Similar bands were formed in 101 of 102 MTBC isolates tested, proving 99.1 per cent sensitivity and no bands were detected in 48 (100%) NTM isolates tested, proving 100 per cent specificity of the ICT kit. INTERPRETATION & CONCLUSIONS Our findings show that ICT test can be used on direct culture positive specimens. It does not require any special equipment, is simple and less time consuming. It can easily discriminate between MTBC and NTM and thus can help in appropriate management of tuberculosis.
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Affiliation(s)
- Anand Kumar Maurya
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Surya Kant
- Department of Pulmonary Medicine, Chhatrapati Shahuji Maharaj Medical University UP, Lucknow, India
| | | | - Manoj Kumar
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Vikas Mishra
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - W. Rahman
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Tapan N. Dhole
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India,Reprint requests: Dr T.N. Dhole, Professor & Head, Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226 014, India e-mail:
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Zhu C, Liu J, Ling Y, Yang H, Liu Z, Zheng R, Qin L, Hu Z. Evaluation of the clinical value of ELISA based on MPT64 antibody aptamer for serological diagnosis of pulmonary tuberculosis. BMC Infect Dis 2012; 12:96. [PMID: 22520654 PMCID: PMC3410803 DOI: 10.1186/1471-2334-12-96] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 04/20/2012] [Indexed: 12/16/2022] Open
Abstract
Background Presently, tuberculosis (TB) poses a global threat to human health. The development of reliable laboratory tools is vital to the diagnosis and treatment of TB. MPT64, a protein secreted by Mycobacterium tuberculosis complex, is highly specific for TB, making antibody to MPT64 a reagent specific for the diagnosis of TB. Method Antibody to MPT64 was obtained by a combination of genetic engineering and immunization by the system evolution of ligands by exponential enrichment. A high-affinity aptamer of antibody to MPT64 was selected from a random single-stranded DNA library, and a sandwich ELISA method based on this aptamer was developed. This ELISA method was used to detect TB in 328 serum samples, 160 from patients with pulmonary TB (PTB) and 168 from non-tuberculous controls. Results The minimum limit of detection of the ELISA method was 2.5 mg/L, and its linear range varied from 10 mg/L to 800 mg/L. Its sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and area under the curve, with 95 % confidence intervals, were 64.4 % (56.7 %–71.4 %), 99.4 % (96.7 %–99.9 %), 108.2 (15.3–765.9), 0.350 (0.291–0.442) and 0.819 (0.770–0.868), respectively. No significant difference in sensitivity was observed between sputum smear positive (73/112, 65.2 %) and negative (30/48, 62.5 %) individuals. Conclusions This sandwich ELISA based on an MPT64 antibody aptamer may be useful for the serological diagnosis of PTB, both in sputum smear positive and negative patients.
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Affiliation(s)
- Changtai Zhu
- Department of Medical Laboratory, Changzhou Tumor Hospital Soochow University, Changzhou 213001, China
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50
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Lee SH, Lee MJ, Lee JM, Yim SJ, Lee SJ, Kim YE, Cho YJ, Jeong YY, Kim HC, Lee JD, Kim SJ, Hwang YS. Usefulness of the BACTEC MGIT 960 System for Mycobacterial Culture and TB Ag MPT64 Immunochromatographic Assay to Identify Mycobacterium tuberculosis. Yeungnam Univ J Med 2012. [DOI: 10.12701/yujm.2012.29.2.83] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Seung Hun Lee
- Department of Internal Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Min Jeong Lee
- Department of Internal Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Jeong-Mi Lee
- Department of Internal Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Su Jin Yim
- Department of Internal Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Seung Jun Lee
- Department of Internal Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - You Eun Kim
- Department of Internal Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Yu Ji Cho
- Department of Internal Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea
- Gyeongsang Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Yi Yeong Jeong
- Department of Internal Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea
- Gyeongsang Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Ho Cheol Kim
- Department of Internal Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea
- Gyeongsang Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Jong Deog Lee
- Department of Internal Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea
- Gyeongsang Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Sun Joo Kim
- Department of Laboratory Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea
- Gyeongsang Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Korea
| | - Young Sil Hwang
- Department of Internal Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea
- Gyeongsang Institute of Health Sciences, School of Medicine, Gyeongsang National University, Jinju, Korea
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