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Dwivedi H, MacDonald K, Angaali N, Garrett S, Klein J, Savidge T, Jacobs MR, Good CE, Lauzardo M, Patil MA, Garner CD, Pincus DH. Multicenter matched-pair study comparing BACT/ALERT® MP reagent systems for the recovery of mycobacteria from specimens other than blood. Diagn Microbiol Infect Dis 2023; 107:115959. [PMID: 37536260 DOI: 10.1016/j.diagmicrobio.2023.115959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 03/29/2023] [Accepted: 04/16/2023] [Indexed: 08/05/2023]
Abstract
The BACT/ALERT® MP Reagent System is a broth culture medium for optimal detection and recovery of mycobacteria from clinical samples. The MP formulation was recently modified to improve detection and recovery times. A multicenter prospective matched pair study design was conducted to validate the performance of improved MP (MP-I) versus current MP (MP-C) bottles utilizing nonsterile and normally sterile samples, except blood, from patients suspected of having mycobacterial infections. A total of 1488 clinical samples were collected to obtain 212 mycobacteria samples by either or both MP culture bottles. MP-I and MP-C sensitivities were 86.6% and 81.4%, respectively, but the difference was not significant (P = 0.163) while specificities were 96.8% and 93.8%, respectively, and that difference was significant (P = 0.002). Overall recovery was 94.34% for MP-I and 88.68% for MP-C (recovery was 100% for both bottles with 52 seeded samples). Overall performance of MP-I was better than MP-C for sensitivity, specificity, and recovery.
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Affiliation(s)
- Hari Dwivedi
- Global Medical Affairs-Microbiology, BioMérieux, Inc., Hazelwood, MO, USA.
| | | | - Neelima Angaali
- Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Sheri Garrett
- Clinical Affairs, BioMérieux, Inc., Hazelwood, MO, USA
| | - Jenna Klein
- R&D Microbiology, BioMérieux, Inc., Durham, NC, USA
| | - Theresa Savidge
- Mycobacteriology Laboratory, National Jewish Health, Denver, CO, USA
| | - Michael R Jacobs
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Caryn E Good
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Michael Lauzardo
- Department of Medicine, UF Emerging Pathogens Institute, Gainesville, FL, USA
| | - M A Patil
- Department of Microbiology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Cherilyn D Garner
- Global Medical Affairs-Microbiology, BioMérieux, Inc., Hazelwood, MO, USA
| | - David H Pincus
- Global Medical Affairs-Microbiology, BioMérieux, Inc., Hazelwood, MO, USA
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2
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Dong B, He Z, Li Y, Xu X, Wang C, Zeng J. Improved Conventional and New Approaches in the Diagnosis of Tuberculosis. Front Microbiol 2022; 13:924410. [PMID: 35711765 PMCID: PMC9195135 DOI: 10.3389/fmicb.2022.924410] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/06/2022] [Indexed: 02/05/2023] Open
Abstract
Tuberculosis (TB) is a life-threatening infectious disease caused by Mycobacterium tuberculosis (M. tuberculosis). Timely diagnosis and effective treatment are essential in the control of TB. Conventional smear microscopy still has low sensitivity and is unable to reveal the drug resistance of this bacterium. The traditional culture-based diagnosis is time-consuming, since usually the results are available after 3–4 weeks. Molecular biology methods fail to differentiate live from dead M. tuberculosis, while diagnostic immunology methods fail to distinguish active from latent TB. In view of these limitations of the existing detection techniques, in addition to the continuous emergence of multidrug-resistant and extensively drug-resistant TB, in recent years there has been an increase in the demand for simple, rapid, accurate and economical point-of-care approaches. This review describes the development, evaluation, and implementation of conventional diagnostic methods for TB and the rapid new approaches for the detection of M. tuberculosis.
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Affiliation(s)
- Baoyu Dong
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zhiqun He
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuqing Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xinyue Xu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chuan Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jumei Zeng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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3
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Campelo TA, Cardoso de Sousa PR, Nogueira LDL, Frota CC, Zuquim Antas PR. Revisiting the methods for detecting Mycobacterium tuberculosis: what has the new millennium brought thus far? Access Microbiol 2021; 3:000245. [PMID: 34595396 PMCID: PMC8479963 DOI: 10.1099/acmi.0.000245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 06/17/2021] [Indexed: 01/07/2023] Open
Abstract
Tuberculosis (TB) affects around 10 million people worldwide in 2019. Approximately 3.4 % of new TB cases are multidrug-resistant. The gold standard method for detecting Mycobacterium tuberculosis, which is the aetiological agent of TB, is still based on microbiological culture procedures, followed by species identification and drug sensitivity testing. Sputum is the most commonly obtained clinical specimen from patients with pulmonary TB. Although smear microscopy is a low-cost and widely used method, its sensitivity is 50-60 %. Thus, owing to the need to improve the performance of current microbiological tests to provide prompt treatment, different methods with varied sensitivity and specificity for TB diagnosis have been developed. Here we discuss the existing methods developed over the past 20 years, including their strengths and weaknesses. In-house and commercial methods have been shown to be promising to achieve rapid diagnosis. Combining methods for mycobacterial detection systems demonstrates a correlation of 100 %. Other assays are useful for the simultaneous detection of M. tuberculosis species and drug-related mutations. Novel approaches have also been employed to rapidly identify and quantify total mycobacteria RNA, including assessments of global gene expression measured in whole blood to identify the risk of TB. Spoligotyping, mass spectrometry and next-generation sequencing are also promising technologies; however, their cost needs to be reduced so that low- and middle-income countries can access them. Because of the large impact of M. tuberculosis infection on public health, the development of new methods in the context of well-designed and -controlled clinical trials might contribute to the improvement of TB infection control.
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Affiliation(s)
- Thales Alves Campelo
- Faculdade de Medicina, Departamento de Patologia e Medicina Legal, Federal University of Ceará, Fortaleza, Brazil
| | | | - Lucas de Lima Nogueira
- Faculdade de Medicina, Departamento de Patologia e Medicina Legal, Federal University of Ceará, Fortaleza, Brazil
| | - Cristiane Cunha Frota
- Faculdade de Medicina, Departamento de Patologia e Medicina Legal, Federal University of Ceará, Fortaleza, Brazil
| | - Paulo Renato Zuquim Antas
- Laboratório de Imunologia Clínica, Instituto Oswaldo Cruz, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Natarajan A, Beena PM, Devnikar AV, Mali S. A systemic review on tuberculosis. Indian J Tuberc 2020; 67:295-311. [PMID: 32825856 DOI: 10.1016/j.ijtb.2020.02.005] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 09/07/2019] [Accepted: 02/18/2020] [Indexed: 12/17/2022]
Abstract
Tuberculosis (TB), which is caused by bacteria of the Mycobacterium tuberculosis complex, is one of the oldest diseases known to affect humans and a major cause of death worldwide. Tuberculosis continues to be a huge peril disease against the human population and according to WHO, tuberculosis is a major killer of the human population after HIV/AIDS. Tuberculosis is highly prevalent among the low socioeconomic section of the population and marginalized sections of the community. In India, National strategic plan (2017-2025) has a national goal of elimination of tuberculosis by 2025. It requires increased awareness and understanding of Tuberculosis. In this review article history, taxonomy, epidemiology, histology, immunology, pathogenesis and clinical features of both pulmonary tuberculosis (PTB) and extra-pulmonary tuberculosis (EPTB) has been discussed. A great length of detailed information regarding diagnostic modalities has been explained along with diagnostic algorithm for PTB and EPTB. Treatment regimen for sensitive, drug resistant and extensive drug resistant tuberculosis has been summarized along with newer drugs recommended for multi drug resistant tuberculosis. This review article has been written after extensive literature study in view of better understanding and to increase awareness regarding tuberculosis, as a sincere effort that will help eliminate tuberculosis off the face of the earth in near future.
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MESH Headings
- Humans
- Algorithms
- Culture Techniques
- Extensively Drug-Resistant Tuberculosis
- History, 15th Century
- History, 16th Century
- History, 17th Century
- History, 18th Century
- History, 19th Century
- History, 20th Century
- History, Ancient
- Interferon-gamma Release Tests
- Mycobacterium tuberculosis
- Nucleic Acid Amplification Techniques
- Polymerase Chain Reaction
- Tuberculin Test
- Tuberculosis/diagnosis
- Tuberculosis/epidemiology
- Tuberculosis/history
- Tuberculosis/immunology
- Tuberculosis, Multidrug-Resistant
- Tuberculosis, Pulmonary/diagnosis
- Tuberculosis, Pulmonary/epidemiology
- Tuberculosis, Pulmonary/history
- Tuberculosis, Pulmonary/immunology
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Affiliation(s)
- Arvind Natarajan
- Department of Microbiology, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, India
| | - P M Beena
- Department of Microbiology, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, India
| | - Anushka V Devnikar
- Department of Microbiology, S Nijalingappa Medical College, Bagalkot, India
| | - Sagar Mali
- SDM Narayanaya Heart Centre, Sri Dharmasthala Manjunatheshwara Medical College, Sri Dharmasthala Manjunatheshwara University, Dharwad, India.
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5
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Evaluation of Microscopy, Culture and PCR Assay in the Diagnosis of Extrapulmonary Tuberculosis. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2018. [DOI: 10.22207/jpam.12.2.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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6
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Fraisse P. Place du diagnostic précoce dans la lutte contre la tuberculose. ACTUALITES PHARMACEUTIQUES 2017. [DOI: 10.1016/j.actpha.2017.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Firdaus S, Kaur IR, Kashyap B, Avasthi R, Singh NP. Front loading sputum microscopy - an alternative approach for diagnosis of pulmonary tuberculosis. J Clin Tuberc Other Mycobact Dis 2017; 8:6-12. [PMID: 31723704 PMCID: PMC6850237 DOI: 10.1016/j.jctube.2017.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 05/15/2017] [Indexed: 11/28/2022] Open
Abstract
Introduction Until newer, rapid, economical tools are introduced for diagnosis of Pulmonary Tuberculosis in resource limited settings, optimization of sputum smear examination for increasing case detection remains of utmost priority. The aim of the study was to detect presumptive TB patients using Front Loading sputum microscopy and compare it with Standard method. Methods Three sputum specimens (Spot 1- on spot at the time of first visit, Spot 2- one hour after Spot 1 and early morning-next day early morning sample) from 552 TB suspect cases were collected. Zeihl Neelsen staining (spot 1, spot 2 and early morning respectively) and microscopy by Front Loading (spot 1, spot 2) and Standard method (spot 1, early morning) of sputum microscopy were done. Results Culture on LJ media being the gold standard, the sensitivity and specificity of the Front Loading and the Standard method of sputum microscopy were 68.65%, 94.43% and 70.14%, 93.6% respectively. The difference between two methods was not statistically significant. 91.1% patients gave preference for same day sampling process. Conclusion The sensitivity and specificity of sputum microscopy using an early morning sample followed by another sputum one hour later from the same day appears not to be inferior to using two early morning samples on subsequent days. The Front Loading sputum microscopy can be implemented in DOTS clinic on the day of first visit of patients to health care center to increase compliance of patients with diagnostic procedure and decrease drop-outs.
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Affiliation(s)
- Shehnaz Firdaus
- Department of Microbiology, University College of Medical Sciences (UCMS) & Guru Teg Bahadur (GTB) Hospital, Delhi, India
| | - Iqbal R Kaur
- Department of Microbiology, University College of Medical Sciences (UCMS) & Guru Teg Bahadur (GTB) Hospital, Delhi, India
| | - Bineeta Kashyap
- Department of Microbiology, University College of Medical Sciences (UCMS) & Guru Teg Bahadur (GTB) Hospital, Delhi, India
| | - Rajnish Avasthi
- Department of Medicine, University College of Medical Sciences (UCMS) & Guru Teg Bahadur (GTB) Hospital, Delhi, India
| | - N P Singh
- Department of Microbiology, University College of Medical Sciences (UCMS) & Guru Teg Bahadur (GTB) Hospital, Delhi, India
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8
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Diriba G, Kebede A, Yaregal Z, Getahun M, Tadesse M, Meaza A, Dagne Z, Moga S, Dilebo J, Gudena K, Hassen M, Desta K. Performance of Mycobacterium Growth Indicator Tube BACTEC 960 with Lowenstein-Jensen method for diagnosis of Mycobacterium tuberculosis at Ethiopian National Tuberculosis Reference Laboratory, Addis Ababa, Ethiopia. BMC Res Notes 2017; 10:181. [PMID: 28486950 PMCID: PMC5424417 DOI: 10.1186/s13104-017-2497-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 04/25/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bacteriological confirmed active case detection remains the corner stone for diagnosing tuberculosis. Non-radiometric liquid culture system Mycobacterium Growth Indicator Tube with automated interface had been recommended by expert groups in addition to conventional solid culture media such as Lowenstein-Jensen. However in high burden resource limited countries advanced non-radiometric based tuberculosis diagnostic methods such as MGIT 960 is limited. Therefore we have evaluated the performance of MGIT 960 system compared to LJ for recovery of Mycobacterium complex (MTBC) from clinical specimens. METHODS A cross sectional study was conducted from a total of 908 samples between January 1st, 2013 to December 31st, 2014. Clinical specimens were processed following standard procedures and the final suspension was inoculated to MGIT tubes and LJ slant. Identification and confirmation of MTBC was done by ZN staining and SD Bioline test. Data was analyzed by SPSS version 20. The sensitivity, specificity, recovery rate and the average turnaround time to recover the organism was computed. RESULTS From a total of 908 clinical specimens processed using both LJ and BACTEC MGIT liquid culture methods the recovery rate for LJ and MGIT, for smear positive samples was 66.7% (74/111) and 87.4% (97/ 111) respectively while for smear negative samples was 13.4% (108/797) and 17.4% (139/797) for LJ and MGIT methods respectively. The overall recovery rate for MGIT is significantly higher than LJ methods [26% (236/908; vs. 20%, 182/908, P = 0.002)]. The average turnaround time for smear positive samples was 16 and 31 days for MGIT and LJ respectively. Turnaround time for smear negative samples was 20 and 36 days for MGIT and LJ respectively. The overall agreement between MGIT and LJ was fairly good with Kappa value of 0.59 (P < 0.001). In the present study the contamination rate for MGIT is higher than the LJ methods, 15 and 9.3% respectively. CONCLUSIONS The BACTEC MGIT liquid culture system has better MTBC recovery rate with shorter turnaround time for both smear positive and negative clinical specimens compared to Conventional LJ method. However, efforts should be made in order to reduce the high contamination rate in BACTEC MGIT system and to lesser extent to LJ methods.
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Affiliation(s)
- Getu Diriba
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia. .,School of Laboratory Science, College of Allied Science, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Abebaw Kebede
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | - Abyot Meaza
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Zekarias Dagne
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Shewki Moga
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Jibril Dilebo
- School of Laboratory Science, College of Allied Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kebebe Gudena
- School of Laboratory Science, College of Allied Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mulu Hassen
- Department of Laboratory Science, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kassu Desta
- Department of Laboratory Science, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Abstract
ABSTRACT
The laboratory, which utilizes some of the most sophisticated and rapidly changing technologies, plays a critical role in the diagnosis of tuberculosis. Some of these tools are being employed in resource-challenged countries for the rapid detection and characterization of
Mycobacterium tuberculosis
. Foremost, the laboratory defines appropriate specimen criteria for optimal test performance. The direct detection of mycobacteria in the clinical specimen, predominantly done by acid-fast staining, may eventually be replaced by rapid-cycle PCR. The widespread use of the Xpert MTB/RIF (Cepheid) assay, which detects both
M. tuberculosis
and key genetic determinants of rifampin resistance, is important for the early detection of multidrug-resistant strains. Culture, using both broth and solid media, remains the standard for establishing the laboratory-based diagnosis of tuberculosis. Cultured isolates are identified far less commonly by traditional biochemical profiling and more commonly by molecular methods, such as DNA probes and broad-range PCR with DNA sequencing. Non-nucleic acid-based methods of identification, such as high-performance liquid chromatography and, more recently, matrix-assisted laser desorption/ionization–time of flight mass spectrometry, may also be used for identification. Cultured isolates of
M. tuberculosis
should be submitted for susceptibility testing according to standard guidelines. The use of broth-based susceptibility testing is recommended to significantly decrease the time to result. Cultured isolates may also be submitted for strain typing for epidemiologic purposes. The use of massive parallel sequencing, also known as next-generation sequencing, promises to continue to this molecular revolution in mycobacteriology, as whole-genome sequencing provides identification, susceptibility, and typing information simultaneously.
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Wang G, Yang X, Zhu J, Dong W, Huang M, Jiang G, Zhao L, Qin S, Chen X, Huang H. Evaluation of the efficacy of Myco/F lytic system, MGIT960 system and Lowenstein-Jensen medium for recovery of Mycobacterium tuberculosis from sterile body fluids. Sci Rep 2016; 6:37757. [PMID: 27876877 PMCID: PMC5120269 DOI: 10.1038/srep37757] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 10/31/2016] [Indexed: 01/15/2023] Open
Abstract
The diagnosis of extrapulmonary tuberculosis (EPTB) is challenging due to non-specific symptoms, invasive approach for specimen collection and most importantly, the paucibacillary status. The objective of this assay was to evaluate the efficacy of Myco/F lytic system, BACTEC Mycobacteria Growth Indicator Tube (MGIT) 960 system and Lowenstein-Jensen (L-J) medium for recovery of bacilli from sterile body fluids. 214 specimens (114 pleural fluid and 100 pus) from clinically diagnosed EPTB patients were collected and subjected to Ziehl-Neelsen (ZN) smear microscopy, L-J culture, MGIT 960 culture and Myco/F lytic culture.103 out of the 214 sterile body fluid samples yielded positive culture outcomes by any of the three methods. Among all the culture positive specimens, the recovery rate was 86.41% for Myco/F lytic, 75.73% for MGIT 960, and 42.72% for L-J medium. The mean time to positivity (TTP) was 27.06 ± 8.03 days for Myco/F lytic, 22.20 ± 7.84 days for MGIT960 and 42 ± 8.84 days for L-J medium. The rates of contamination were 6.54%, 3.74% and 2.80% for Myco/F lytic, MGIT960 and L-J medium respectively. Both Myco/F lytic and MGIT960 system were superior to L-J medium for recovery of bacilli from sterile body fluids. Myco/F lytic system was more favorable than MGIT960 regarding recovery rate and cost-effectiveness, thus can be considered as a promising alternative to MGIT960 system for diagnosing EPTB.
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Affiliation(s)
- Guirong Wang
- National Clinical Laboratory on Tuberculosis, Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, China
| | - Xinting Yang
- Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, China
| | - Junping Zhu
- Department of Pathogenic Biology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Weijie Dong
- Department of Orthopedics, Beijing Bone and Joint Tuberculosis Diagnosis and Treatment Center, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, China
| | - Mailing Huang
- Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, China
| | - Guanglu Jiang
- National Clinical Laboratory on Tuberculosis, Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, China
| | - Liping Zhao
- National Clinical Laboratory on Tuberculosis, Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, China
| | - Sibing Qin
- Department of Orthopedics, Beijing Bone and Joint Tuberculosis Diagnosis and Treatment Center, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, China
| | - Xiaoyou Chen
- Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, China
| | - Hairong Huang
- National Clinical Laboratory on Tuberculosis, Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, China
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A Flow Cytometry Method for Rapidly Assessing Mycobacterium tuberculosis Responses to Antibiotics with Different Modes of Action. Antimicrob Agents Chemother 2016; 60:3869-83. [PMID: 26902767 PMCID: PMC4914659 DOI: 10.1128/aac.02712-15] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 02/13/2016] [Indexed: 12/22/2022] Open
Abstract
Current methods for assessing the drug susceptibility of Mycobacterium tuberculosis are lengthy and do not capture information about viable organisms that are not immediately culturable under standard laboratory conditions as a result of antibiotic exposure. We have developed a rapid dual-fluorescence flow cytometry method using markers for cell viability and death. We show that the fluorescent marker calcein violet with an acetoxy-methyl ester group (CV-AM) can differentiate between populations of M. tuberculosis growing at different rates, while Sytox green (SG) can differentiate between live and dead mycobacteria. M. tuberculosis was exposed to isoniazid or rifampin at different concentrations over time and either dual stained with CV-AM and SG and analyzed by flow cytometry or plated to determine the viability of the cells. Although similar trends in the loss of viability were observed when the results of flow cytometry and the plate counting methods were compared, there was a lack of correlation between these two approaches, as the flow cytometry analysis potentially captured information about cell populations that were unable to grow under standard conditions. The flow cytometry approach had an additional advantage in that it could provide insights into the mode of action of the drug: antibiotics targeting the cell wall gave a flow cytometry profile distinct from those inhibiting intracellular processes. This rapid drug susceptibility testing method could identify more effective antimycobacterials, provide information about their potential mode of action, and accelerate their progress to the clinic.
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12
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Addise D, Bitew A, Yaregal Z, Yenew B, Mollalign H, Diriba G, Kebede A. Effect of 1.5% sodium hydroxide final concentration on recovery rate of Mycobacterial Species and decontamination of other Bacterial and Fungal contaminants on sputum. ETHIOPIAN JOURNAL OF PUBLIC HEALTH AND NUTRITION 2016; 1:57-67. [PMID: 30976752 PMCID: PMC6454901] [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 Digestion and decontamination of non-sterile clinical specimens such as sputum are an essential step in the isolation of mycobacteria. Masking of mycobacteria in Mycobacterial growth indicator tube (MGIT) 960 liquid culture system by fungi and bacteria other than mycobacteria is a major problem. OBJECTIVE To assess the effect of 1.5% sodium hydroxide final concentration on recovery rate of mycobacterial species and decontamination of other bacterial and fungal contaminants from sputum sample. METHODOLOGY Laboratory based cross sectional study with convenient sampling technique was carried out on subjects referred to the National Tuberculosis Reference Laboratory of Ethiopian Public Health Institute from November 2015 to February 2016. Single morning sputum was collected from each patient and analyzed. RESULTS A total of 264 subjects were enrolled in the study. The mean age of participant was 31 (SD 20.14 - 41.42) years old. The majority (61%) were male. Increasing the final concentration of NaOH from 1% to 1.5% reduced the contamination rate from 22.4% to 6.8% (P<0.001) without affecting mycobacterial recovery (P=1.00). A total of 26 different species of microbial contaminants were identified as being associated with BACTEC MGIT 960 culture system. CONCLUSION Results presented in this study demonstrated that the use of a final concentration of 1.5% NaOH with NALC method aids in reducing culture contamination rate for decontaminating sputum samples referred for tuberculosis culture diagnosis. Among the identified microbial contaminants, the most predominant was coagulase negative Staphylococcus species.
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Affiliation(s)
- Desalegn Addise
- Ethiopian Public Health Institute, TB/HIV Directorate, TB Research Team, P.O.BOX 1242, Addis Ababa, Ethiopia
| | - Adane Bitew
- Addis Ababa University, College of Health Science, Department of Medical Laboratory Sciences, Addis Ababa, Ethiopia
| | - Zelalem Yaregal
- Ethiopian Public Health Institute, TB/HIV Directorate, TB Research Team, P.O.BOX 1242, Addis Ababa, Ethiopia
| | - Bazezew Yenew
- Ethiopian Public Health Institute, TB/HIV Directorate, TB Research Team, P.O.BOX 1242, Addis Ababa, Ethiopia
| | - Helina Mollalign
- Ethiopian Public Health Institute, TB/HIV Directorate, TB Research Team, P.O.BOX 1242, Addis Ababa, Ethiopia
| | - Getu Diriba
- Ethiopian Public Health Institute, TB/HIV Directorate, TB Research Team, P.O.BOX 1242, Addis Ababa, Ethiopia
| | - Abebaw Kebede
- Ethiopian Public Health Institute, TB/HIV Directorate, TB Research Team, P.O.BOX 1242, Addis Ababa, Ethiopia
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Liu X, Jia W, Wang H, Wang Y, Ma J, Wang H, Zhou X, Li G. Retraction: Establishment of a Rabbit Model of Spinal Tuberculosis Using Mycobacterium tuberculosis Strain H37Rv. Jpn J Infect Dis 2015; 68:89-97. [DOI: 10.7883/yoken.jjid.2014.147] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Xiaochen Liu
- Department of Image, the First Affiliated Hospital of XinJiang Medical University
| | - Wenxiao Jia
- Department of Image, the Second Affiliated Hospital of XinJiang Medical University
| | - Hong Wang
- Department of Image, the Second Affiliated Hospital of XinJiang Medical University
| | - Yunling Wang
- Department of Image, the Second Affiliated Hospital of XinJiang Medical University
| | - Jingxun Ma
- Department of Image, the Second Affiliated Hospital of XinJiang Medical University
| | - Hao Wang
- Department of Image, the Second Affiliated Hospital of XinJiang Medical University
| | - Xuan Zhou
- Department of Image, the Second Affiliated Hospital of XinJiang Medical University
| | - Guohua Li
- Department of Spine surgery, the Second Affiliated Hospital of XinJiang Medical University
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Gupta A, Anupurba S. Detection of drug resistance in Mycobacterium tuberculosis: Methods, principles and applications. ACTA ACUST UNITED AC 2015; 62:13-22. [DOI: 10.1016/j.ijtb.2015.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Comparative study between using Lowenstein Jensen and Bio-FM media in identification of Mycobacterium tuberculosis. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2013. [DOI: 10.1016/j.ejcdt.2013.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Domig KJ, Zitz U, Macher S, Kronberger A, Reiter A, Kneifel W. Selective colorimetric detection of Gram-negative re-contaminants in pasteurised milk products by a novel application of the BacT/ALERT 3D system. Int Dairy J 2013. [DOI: 10.1016/j.idairyj.2012.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Short-term storage does not affect the quantitative yield of Mycobacterium tuberculosis in sputum in early-bactericidal-activity studies. J Clin Microbiol 2013; 51:1094-8. [PMID: 23345289 DOI: 10.1128/jcm.02751-12] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Early-bactericidal-activity (EBA) studies measure the change in mycobacterial load in sputum over time to evaluate antituberculosis drugs. We investigated whether a delay in sputum processing influences the quantitative results of sputum mycobacterial culture. We identified pretreatment smear-positive sputum samples collected overnight and processed at a single laboratory. Sputum volume, time from sputum collection to processing, CFU counts/ml of sputum, and time to culture positivity (TTP) data were retrieved. We obtained 817 TTP and 794 CFU results from a total of 844 sputum samples. Contamination did not occur more frequently with prolonged storage (TTP, 2.0%; CFU, 2.4%). Sample volumes were <5 ml in 5%, 5 to 10 ml in 46%, and >10 ml in 49%. Delays to processing were 0, 1, 2, and 3 days in 696 (43.2%), 722 (44.8%), 128 (7.9%), and 65 (4.0%) samples, respectively. TTP and CFU did not significantly differ between days of delay to processing (P = 0.098 and P = 0.908, respectively), but there was a nonsignificant trend toward a prolonged TTP over time (P = 0.052, Jonckheere-Terpstra trend test). Sputa of <5 ml in volume showed a significantly prolonged TTP compared to sputum of >5 ml (113 h versus 99 h; P < 0.01) but no significant decrease in CFU. Sputum can be stored under refrigerated conditions for deferred processing for at least 3 days. This means that central laboratories can be used for quantitative mycobacterial study endpoints when delays to processing are not expected to exceed a few days. Care should be taken to collect sputum of sufficient volume.
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Sastry AS, Bhat K S, Kumudavathi. The Diagnostic Utility of Bact/ALERT and Nested PCR in the Diagnosis of Tuberculous Meningitis. J Clin Diagn Res 2013; 7:74-8. [PMID: 23450650 DOI: 10.7860/jcdr/2012/5098.2674] [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: 09/17/2012] [Accepted: 11/07/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The early laboratory diagnosis of Tuberculous Meningitis (TBM) is crucial, to start the antitubercular chemotherapy and to prevent its complications. However, the conventional methods are either less sensitive or time consuming. Hence, the diagnostic potentials of BacT/ALERT and Polymerase Chain Reaction (PCR) was evaluated in this study. MATERIAL AND METHOD The study group comprised of 62 cases and 33 controls. The cases were divided according to Ahuja's criteria into the confirmed (two cases), highly probable (19 cases), probable (26 cases) and the possible (15 cases) subgroups. Ziehl Neelsen's (ZN) and Auramine Phenol (AP) staining, Lowenstein Jensen (LJ) medium culture, BacT/ALERT and nested Polymerase Chain Reaction (PCR) which targeted IS6110 were carried out on all the patients. OBSERVATION AND RESULTS The sensitivity of the LJ culture was 3.22%. BacT/ALERT showed a sensitivity and a specificity of 25.80% and 100% and those of nested PCR were found to be 40.32% and 96.97% respectively. The mean detection time of growth of the LJ culture was 31.28 days, whereas that of BacT/ALERT was 20.68 days. The contamination rate in the LJ culture and BacT/ALERT were 7.2% and 5.8% respectively. CONCLUSION Nested PCR was found to be more sensitive, followed by BacT/ALERT as compared to the LJ culture and smear microscopy. As both false negative and false positive results have been reported for nested PCR, so it should not be used alone as a criterion for initiating or terminating the therapy, but it should be supported by clinical, radiological, cytological and other microbiological findings.
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Naveen G, Peerapur BV. Comparison of the Lowenstein-Jensen Medium, the Middlebrook 7H10 Medium and MB/BacT for the Isolation of Mycobacterium Tuberculosis (MTB) from Clinical Specimens. J Clin Diagn Res 2012; 6:1704-9. [PMID: 23373033 DOI: 10.7860/jcdr/2012/4603.2635] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 11/06/2012] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Tuberculosis (TB) is the most common cause of death due to a single infectious agent worldwide in adults. India alone accounts for 30% of the global tuberculosis burden. There is a need for a method of cultivation of mycobacteria that is reliable and economical and has a short turnaround time. OBJECTIVE The present study was attempted to assess the feasibility of using MB BACT and Middlebrook 7h10(MB7H10) as primary isolation media for mycobacteria. They were compared with the LJ medium, which was the gold standard. MATERIALS AND METHODS Various clinical specimens from a total of 236 clinically suspected cases of TB were studied. All the samples were decontaminated by using the modified Petroff's method. Each sample was subjected to ZN staining and it was simultaneously inoculated onto the LJ medium, the MB7H10 medium and MB BACT. The growth from the cultures were confirmed by ZN staining and they were speciated by using biochemical reactions. RESULTS Out of the 236 samples which were screened, 116 isolates were obtained. All the 116 were isolated from MB BACT, 82 were isolated from the LJ medium and 62 were isolated from MB7H10. 82 isolates were obtained from MB BACT and the LJ medium, 62 were obtained from MB7H10 and MB BACT, 58 were isolated from LJ and MB7H10 and 58 were isolated from LJ medium, MB7H10 and MB bact. Neither the L J medium nor the Middlebrook 7h 10 medium could isolate mycobacteria exclusively. It showed that the combination of media did not prove to be superior over the use of MB BACT alone. The average isolation time of L J, the MB7H10 medium and MB BACT was 30.81 days, 31.06 days and 18.70 days. INTERPRETATION AND CONCLUSION MB BACT is a better medium as compared to the L J medium and the MB7H10 medium, both in terms of the number of isolates and the isolation rate. The MB BACT method proved to be a very speedy method and it could isolate mycobacteria 7-10 days earlier as compared to the L J medium and the Middlebrook 7 H10 medium.
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Affiliation(s)
- G Naveen
- Assistant Professor, Department of Microbiology, Travancore Medical College , Medicity, NH bypass, Mylapore,Umayanalloor, P O Kollam 691589, kerala, India
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Tyrrell FC, Budnick GE, Elliott T, Gillim-Ross L, Hildred MV, Mahlmeister P, Parrish N, Pentella M, Vanneste J, Wang YFW, Starks AM. Probability of negative mycobacterium tuberculosis complex cultures based on time to detection of positive cultures: a multicenter evaluation of commercial-broth-based culture systems. J Clin Microbiol 2012; 50:3275-82. [PMID: 22837326 PMCID: PMC3457445 DOI: 10.1128/jcm.01225-12] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 07/19/2012] [Indexed: 11/20/2022] Open
Abstract
We conducted a multicenter study to determine whether Mycobacterium tuberculosis complex (MTBC) cultures in automated broth-based systems could reliably be considered negative sooner than 6 weeks. Laboratory sites used Bactec MGIT or BacT/Alert and tracked results of time to detection of all mycobacteria (TTD-all, n = 1547) and of MTBC (TTD-MTBC, n = 466) over 6-month periods from primarily (93%) respiratory specimens. Cumulative percentages by day detected and median TTD of initial and follow-up specimens were analyzed. The median TTD-MTBC for MGIT (n = 6 sites) was 14 days. For laboratories using standard processing procedures, 100% of MTBC were detected from initial and follow-up specimens in 28 and 35 days, respectively, and no yield of MTBC on solid or MGIT liquid media was observed after 5 weeks. The median TTD-MTBC for BacT/Alert (n = 3 sites) was 18 days, with 95% and 100% detected within 37 and 42 days, respectively. Analysis of TTD of positive MTBC cultures in broth can predict the probability of culture negativity at defined time points. Receipt of interim negative reports earlier than 6 weeks could assist clinicians in considering alternative diagnoses and could alter the timing and prioritization of public health interventions. Laboratories should analyze their own TTD data to inform protocol decisions. Laboratories using MGIT could issue reports of no growth of MTBC on initial specimens as early as 4 weeks and for patients undergoing treatment as early as 5 weeks postinoculation.
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Novel real-time simultaneous amplification and testing method to accurately and rapidly detect Mycobacterium tuberculosis complex. J Clin Microbiol 2012; 50:646-50. [PMID: 22205804 DOI: 10.1128/jcm.05853-11] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to establish and evaluate a simultaneous amplification and testing method for detection of the Mycobacterium tuberculosis complex (SAT-TB assay) in clinical specimens by using isothermal RNA amplification and real-time fluorescence detection. In the SAT-TB assay, a 170-bp M. tuberculosis 16S rRNA fragment is reverse transcribed to DNA by use of Moloney murine leukemia virus (M-MLV) reverse transcriptase, using specific primers incorporating the T7 promoter sequence, and undergoes successive cycles of amplification using T7 RNA polymerase. Using a real-time PCR instrument, hybridization of an internal 6-carboxyfluorescein-4-[4-(dimethylamino)phenylazo] benzoic acid N-succinimidyl ester (FAM-DABCYL)-labeled fluorescent probe can be used to detect RNA amplification. The SAT-TB assay takes less than 1.5 h to perform, and the sensitivity of the assay for detection of M. tuberculosis H37Rv is 100 CFU/ml. The TB probe has no cross-reactivity with nontuberculous mycobacteria or other common respiratory tract pathogens. For 253 pulmonary tuberculosis (PTB) specimens and 134 non-TB specimens, the SAT-TB results correlated with 95.6% (370/387 specimens) of the Bactec MGIT 960 culture assay results. The sensitivity, specificity, and positive and negative predictive values of the SAT-TB test for the diagnosis of PTB were 67.6%, 100%, 100%, and 62.0%, respectively, compared to 61.7%, 100%, 100%, and 58.0% for Bactec MGIT 960 culture. For PTB diagnosis, the sensitivities of the SAT-TB and Bactec MGIT 960 culture methods were 97.6% and 95.9%, respectively, for smear-positive specimens and 39.2% and 30.2%, respectively, for smear-negative specimens. In conclusion, the SAT-TB assay is a novel, simple test with a high specificity which may enhance the detection rate of TB. It is therefore a promising tool for rapid diagnosis of M. tuberculosis infection in clinical microbiology laboratories.
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Rate of recovery of Mycobacterium tuberculosis from frozen acid-fast-bacillus smear-positive sputum samples subjected to long-term storage in Northwest Ethiopia. J Clin Microbiol 2011; 49:2557-61. [PMID: 21562105 DOI: 10.1128/jcm.00059-11] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Tuberculosis is a major public health problem in Ethiopia. The diagnosis and treatment of drug-resistant tuberculosis remain a challenge in the country. This study aimed to assess whether single morning sputum samples could be stored at -20 °C for extended periods of time at remote settings and then transported and successfully cultured for Mycobacterium tuberculosis. Single morning sputum samples were collected from all smear-positive tuberculosis patients diagnosed at Gondar Hospital, Gondar Health Center, Metemma Hospital, Bahir Dar Hospital, and Debre Markos Hospital in Northwest Ethiopia between March and July 2009. Specimens were stored at the study sites and sent to the mycobacteriology laboratory at the University Hospital, Leipzig, Germany, where specimens were processed and inoculated into the BacT/Alert 3D system and Lowenstein-Jensen and Gottsacker media. Ice packs were added in the package of the specimens during transport. A total of 319 patients were enrolled in this study. The median specimen storage time was 132 days (range, 16 to 180 days). Of all specimens, 283 (88.7%) were culture positive by any of the three culturing systems. M. tuberculosis isolates from four contaminated specimens in all culturing systems were successfully isolated on Middlebrook 7H10 agar; thereby, the recovery rate increased to 287 (90.0%). The length of time of sputum storage had no significant effect on the rate of recovery of M. tuberculosis in all culturing systems. In conclusion, single morning sputum specimens collected at remote settings stored at -20 °C for long periods of time without the addition of preservatives can yield a high recovery rate. These findings suggest a simple and cost-effective alternative method of sputum storage for epidemiological and drug resistance studies in low-resource countries.
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Godreuil S, Marchandin H, Terru D, Le Moing V, Chammas M, Vincent V, Jumas-Bilak E, Van De Perre P, Carriere C. Mycobacterium heckeshornense tenosynovitis. ACTA ACUST UNITED AC 2009; 38:1098-101. [PMID: 17148085 DOI: 10.1080/00365540600606606] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We describe the first case of tenosynovitis due to Mycobacterium heckeshornense, a mycobacterium characterized in 2000 and only incriminated in a few previous cases of infections. Molecular identification of this pathogen included 16S rRNA and hsp65 gene sequencing. M. heckeshornense may cause a wide spectrum of human infectious diseases and may be underestimated due to its phenotypic relatedness with Mycobacterium xenopi.
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Affiliation(s)
- Sylvain Godreuil
- Laboratoire de Bactériologie, Hôpital Arnaud de Villeneuve, Montpellier, France.
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Parrish N, Carrol K. Importance of improved TB diagnostics in addressing the extensively drug-resistant TB crisis. Future Microbiol 2008; 3:405-13. [PMID: 18651812 DOI: 10.2217/17460913.3.4.405] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
There is an urgent need for new, rapid diagnostics to stem the tide of multidrug-resistant (MDR) and extensively drug-resistant (XDR) TB. Current identification and detection of resistance for the majority of Mycobacteria, including Mycobacterium tuberculosis, require weeks and multiple methodologies to complete. The sheer number and variety of tests required often exceeds the capacity of many laboratories. Current strategies center on improvement of existing tests and development of novel ones. Ultimately, what is needed is a single, rapid, diagnostic for identification and determination of drug resistance in M. tuberculosis. Such a method should be capable of detecting antibiotic resistance for all first- and second-line agents irrespective of the genetic mechanism of resistance. Detection should be achievable directly from clinical specimens. Yet, improved diagnostics are only part of a larger solution. Such a solution must include a comprehensive approach in which careful consideration is given to each particular setting relative to local resources and overall burden of disease. Such an approach is essential for the future of TB control and stemming the tide of MDR-TB and XDR-TB.
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Affiliation(s)
- Nicole Parrish
- The Johns Hopkins Medical Institutions, Johns Hopkins University, 600 North Wolfe Street, Meyer B1-193, Baltimore, MD 21287, USA.
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Gouveia ACC, Eisenach KD, Vinhas SA, Ribeiro FKC, Peres RL, Dietze R, Hadad DJ, Palaci M. Use of in-house PCR for identification of Mycobacterium tuberculosis in BACTEC broth cultures of respiratory specimens. Mem Inst Oswaldo Cruz 2008; 103:386-91. [DOI: 10.1590/s0074-02762008000400012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Accepted: 06/20/2008] [Indexed: 11/22/2022] Open
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O'Sullivan DM, Sander C, Shorten RJ, Gillespie SH, Hill AVS, McHugh TD, McShane H, Tchilian EZ. Evaluation of liquid culture for quantitation of Mycobacterium tuberculosis in murine models. Vaccine 2007; 25:8203-5. [PMID: 17980937 DOI: 10.1016/j.vaccine.2007.09.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2007] [Accepted: 09/12/2007] [Indexed: 11/18/2022]
Abstract
Quantitation of bacterial load in tissues is essential for experimental investigation of Mycobacterium tuberculosis infection and immunity. We have used an automated liquid culture system to determine the number of colony forming units (CFU) in murine tissues and compared the results to those obtained by conventional plating on Middlebrook agar. There is an overall good correlation between results obtained by the two methods. Although less consistency and more contamination was observed in the automated liquid culture, the method is more sensitive, less labour intensive and allows the processing of large numbers of samples.
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Venkataswamy MM, Rafi W, Nagarathna S, Ravi V, Chandramuki A. COMPARATIVE EVALUATION OF BACTEC 460TB SYSTEM AND LOWENSTEIN-JENSEN MEDIUM FOR THE ISOLATION OF M. TUBERCULOSIS FROM CEREBROSPINAL FLUID SAMPLES OF TUBERCULOUS MENINGITIS PATIENTS. Indian J Med Microbiol 2007. [DOI: 10.1016/s0255-0857(21)02112-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Affiliation(s)
- Mark D Johnson
- Department of Medicine, National Naval Medical Center, Bethesda, MD, USA
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Adler H, Straub C, Frei R. Comparison of BacT/ALERT 3D, Lowenstein-Jensen medium and Middlebrook 7H10/7H11 biplate for recovering mycobacteria from clinical specimens. Eur J Clin Microbiol Infect Dis 2005; 24:499-500. [PMID: 15986232 DOI: 10.1007/s10096-005-1362-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- H Adler
- Microbiology Laboratory, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
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Dionne K, Sweeney A, Hedgepeth A, Carroll K, Parrish N. Methods for reducing bacterial contamination in the BacT/Alert mycobacterial culture detection system. J Clin Microbiol 2005; 43:2523-5. [PMID: 15872302 PMCID: PMC1153766 DOI: 10.1128/jcm.43.5.2523-2525.2005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Two methods were compared for decreasing bacterial contamination in the BacT/Alert mycobacterial culture detection system. Two concentrations, 0.5 ml (standard amount) and 1.0 ml, of mycobacterial antibiotic supplement were evaluated. Contamination rates were 14% and 6% for the standard and the doubled concentrations, respectively. This difference was statistically significant (P < 0.005).
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Affiliation(s)
- Kim Dionne
- Division of Medical Microbiology, Johns Hopkins University, Meyer B1-193, 600 N. Wolfe Street, Baltimore, MD 21287, USA
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Blanie M, Pellegrin JL, Maugein J. Apport de la PCR dans le diagnostic des tuberculoses extrapulmonaires. Med Mal Infect 2005; 35:17-22. [PMID: 15695028 DOI: 10.1016/j.medmal.2004.08.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2004] [Accepted: 08/23/2004] [Indexed: 11/22/2022]
Abstract
UNLABELLED Extrapulmonary tuberculosis is usually more difficult to diagnose than pulmonary tuberculosis. It often involves inaccessible sites and it is paucibacillary. OBJECTIVE AND METHOD In this study, we tried to analyze the performance of various bacteriological methods used to diagnose 51 cases of extrapulmonary tuberculosis in an infectious diseases ward. RESULTS AND COMMENTS The culture was positive for 55% of patients. The new amplification methods used were very disappointing for the testing of nonrespiratory samples. The sensitivity of PCR was 32% compared to that of diagnostic culture which remains the most sensitive reference method. Liquid media allow for rapid growth and limit the contaminations. The combined inoculation of liquid and solid medium increases the sensitivity and helps to identify the pathogen.
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Affiliation(s)
- M Blanie
- Service d'hygiène hospitalière, centre hospitalier Périgueux, 80, avenue Georges-Pompidou, 24019 Périgueux cedex, France.
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Richter E, Weizenegger M, Fahr AM, Rüsch-Gerdes S. Usefulness of the GenoType MTBC assay for differentiating species of the Mycobacterium tuberculosis complex in cultures obtained from clinical specimens. J Clin Microbiol 2004; 42:4303-6. [PMID: 15365028 PMCID: PMC516283 DOI: 10.1128/jcm.42.9.4303-4306.2004] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A novel DNA strip assay, GenoType MTBC, was evaluated for differentiation of Mycobacterium tuberculosis complex species from 77 positive liquid cultures in clinical practice. Species identification (M. tuberculosis [71 strains], Mycobacterium bovis subsp. bovis [5 strains], and Mycobacterium africanum subtype I [1 strain]) results were identical to conventional results. The sensitivity was slightly higher for this test than for the AccuProbe assay.
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Affiliation(s)
- Elvira Richter
- Forschungszentrum Borstel, National Reference Center for Mycobacteria, Parkallee 18, 23845 Borstel, Germany.
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Angeby KAK, Werngren J, Toro JC, Hedström G, Petrini B, Hoffner SE. Evaluation of the BacT/ALERT 3D system for recovery and drug susceptibility testing of Mycobacterium tuberculosis. Clin Microbiol Infect 2003; 9:1148-52. [PMID: 14616736 DOI: 10.1046/j.1469-0691.2003.00783.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We evaluated the BacT/ALERT 3D system for recovery and drug susceptibility testing (DST) of Mycobacterium tuberculosis (MTB). Of 2659 clinical specimens, MTB was detected in 92 using BacT/ALERT, compared to 94 using Löwenstein-Jensen culture. Detection time was 25% shorter with BacT/ALERT. Sensitivities were 92%, 96%, 78% and 100% for resistance to rifampicin, isoniazid, streptomycin and ethambutol, respectively, while specificity was 100% for all antibiotics, when BacT/ALERT was compared with the BACTEC 460 method on 50 MTB isolates. The BacT/ALERT system is fully automated and creates no radioactive waste. It seems to be a valid alternative for primary isolation, but further evaluation is needed regarding DST.
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Affiliation(s)
- K A K Angeby
- Department of Bacteriology, Swedish Institute for Infectious Disease Control, 171 82 Solna, Sweden.
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Crump JA, Reller LB. Two decades of disseminated tuberculosis at a university medical center: the expanding role of mycobacterial blood culture. Clin Infect Dis 2003; 37:1037-43. [PMID: 14523767 DOI: 10.1086/378273] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2002] [Accepted: 06/05/2003] [Indexed: 11/03/2022] Open
Abstract
We describe the clinical presentation, predisposing conditions, diagnostic approach, and outcome for 52 patients with disseminated tuberculosis who presented at Duke University Medical Center (Durham, NC) from 1980 through 1999. The mean age of the patients was 52 years (range, 2-93 years). Fever and weight loss were common at presentation, and delays in the initiation of therapy often occurred. Predisposing conditions included human immunodeficiency virus infection (46% of patients), immunosuppressive therapy (21%), alcoholism (12%), diabetes mellitus (12%), and hematologic disorders (8%); 17% of patients had no disorder of immunity detected. Examination of biopsy specimens from sites of localized disease, especially lymph nodes, had a high diagnostic yield. In this study, mycobacterial blood culture appeared to be as sensitive as bone marrow culture in diagnosing disseminated tuberculosis (sensitivity, 58% vs. 54%). To diagnose disseminated tuberculosis, a search for sites of localized disease should be undertaken, and samples from these sites should be obtained. Mycobacterial blood culture can play an increasing role in the diagnosis of disseminated tuberculosis when localized disease is not found.
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Affiliation(s)
- John A Crump
- Clinical Microbiology Laboratory, Duke University Medical Center, Durham, North Carolina 27710, USA.
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Manterola JM, Thornton CG, Padilla E, Lonca J, Pérez M, Quesada MD, Ausina V. Analysis of the contaminant spectrum in the MB/BacT liquid culture system following C(18)-carboxypropylbetaine specimen processing. Eur J Clin Microbiol Infect Dis 2003; 22:507-8. [PMID: 12884071 DOI: 10.1007/s10096-003-0977-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J M Manterola
- Servicio de Microbiología, Hospital Universitario Germans Trias i Pujol, Carretera de Canyet s/n, 08916, Badalona, Spain
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Crump JA, Tanner DC, Mirrett S, McKnight CM, Reller LB. Controlled comparison of BACTEC 13A, MYCO/F LYTIC, BacT/ALERT MB, and ISOLATOR 10 systems for detection of mycobacteremia. J Clin Microbiol 2003; 41:1987-90. [PMID: 12734238 PMCID: PMC154703 DOI: 10.1128/jcm.41.5.1987-1990.2003] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To compare the performance of the BACTEC 13A (Becton Dickinson, Sparks, Md.), BACTEC MYCO/F LYTIC (Becton Dickinson), BacT/ALERT MB (bioMérieux, Durham, N.C.), and ISOLATOR 10 lysis-centrifugation (Wampole Laboratories, Cranbury, N.J.) systems for detection of mycobacteremia in adults, we inoculated 5-ml aliquots of blood from patients with suspected mycobacteremia into the bottle or tube required for each system. Of 600 sets tested, 85 (14%) yielded Mycobacterium avium complex (MAC) and 9 (2%) yielded other species of mycobacteria. Of 26 complete (three bottles and one tube) adequately filled (5 +/- 1 ml) sets from which MAC was recovered, BACTEC 13A was positive for 19 (73%), BACTEC MYCO/F LYTIC was positive for 21 (81%), BacT/ALERT MB was positive for 22 (85%), and ISOLATOR 10 was positive for 21 (81%). Of the six possible two-way comparisons, the mean times to detection for the recovery of MAC from each bottle in positive adequately paired sets were 15.3 days for BACTEC 13A versus 12.8 days for MYCO/F LYTIC for 33 of 340 pairs, 14.1 days for BACTEC 13A versus 11.6 days for BacT/ALERT MB for 38 of 380 pairs, 12.6 days for BACTEC 13A versus 20.0 days for ISOLATOR 10 for 26 of 261 pairs, 12.8 days for BACTEC MYCO/F LYTIC versus 11.0 days for BacT/ALERT MB for 33 of 340 pairs, 13.2 days for BACTEC MYCO/F LYTIC versus 20.4 days for ISOLATOR 10 for 24 of 230 pairs, and 9.9 days for BacT/ALERT MB versus 19.0 days for ISOLATOR 10 for 24 of 257 pairs. There were no significant differences in yields between the systems. However, the mean time to detection differed significantly among the systems. The time to detection was shortest for BacT/ALERT MB, followed by BACTEC MYCO/F LYTIC and BACTEC 13A and then ISOLATOR 10. Although the numbers were too small for statistical comparison, the time to detection was substantially shorter for MAC than for Mycobacterium tuberculosis complex in the liquid systems. The continuously monitored systems (BACTEC MYCO/F LYTIC and BacT/ALERT MB) were as sensitive and, on balance, faster for the detection of MAC bacteremia than were the heretofore standard manual ISOLATOR 10 and radiometric BACTEC 13A systems.
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Affiliation(s)
- John A Crump
- Clinical Microbiology Laboratory, Duke University Medical Center and Department of Medicine, Duke University School of Medicine, Durham, North Carolina 27710, USA
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39
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Drobniewski FA, Caws M, Gibson A, Young D. Modern laboratory diagnosis of tuberculosis. THE LANCET. INFECTIOUS DISEASES 2003; 3:141-7. [PMID: 12614730 DOI: 10.1016/s1473-3099(03)00544-9] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
One-third of the global population is believed to be infected with bacteria of the Mycobacterium tuberculosis complex, the causative agent of tuberculosis. More than 8 million new cases of tuberculosis occur annually leading to 2 million deaths. Mortality is particularly high in those coinfected with HIV and where the bacteria are multiple-drug-resistant strains--ie, strains resistant to at least isoniazid and rifampicin. Early diagnosis of tuberculosis and drug resistance improves survival and by identifying infectious cases promotes contact tracing, implementation of institutional cross-infection procedures, and other public-health actions. This review addresses significant advances made in the diagnosis of infection, clinical disease, and drug resistance over the past decade. It proposes operational criteria for a modern diagnostic service in the UK (as a model of a low-incidence country) and explores some of the economic issues surrounding the use of these techniques.
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Affiliation(s)
- F A Drobniewski
- PHLS Mycobacterium Reference Unit and Department of Infection, Guy's King's and St Thomas' Medical College, King's College Hospital (Dulwich) London, UK.
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40
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Melzer M, Warley A, Milburn H, O'Sullivan D, Barker RD, Hutchinson D, Shelton D, Drobniewski F, French G. Tuberculosis and HIV seroprevalence in Lambeth, Southwark and Lewisham, an area of South London. Respir Med 2003; 97:167-72. [PMID: 12587968 DOI: 10.1053/rmed.2003.1399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Since the mid-1980s the number of cases of TB notified within the U.K. has continued to rise although the contribution of HIV to this rise remains unclear. A 12-month prospective cohort study was conducted at chest and HIV clinics in four hospitals in Lambeth, Southwark and Lewisham (LSL), an area of South London, to determine the proportion of patients with culture-proven TB infected with HIV. Secondary aims were to determine the proportion of patients with TB and undiagnosed HIV at first presentation to chest clinics, to determine the proportion of patients presenting with TB as an AIDS defining illness (ADI) and to identify risk factors for co-infection with TB and HIV. In chest clinics, demographic data and left-over blood from patients aged 16 or over with culture-proven TB was collected, anonymised and HIV tested. In HIV clinics, demographic data on patients with TB already known to be HIV seropositive were also obtained. Twenty-one patients (13%, 95% CI-8-19%) of 159 with culture-proven TB were infected with HIV Four (3%) of 133 patients at first presentation to chest clinics had undiagnosed HIV; two were subsequently diagnosed. Of the 21 patients withTB and HIV, nine (43%) presented with TB as an ADI. Patients with TB and HIV were significantly more likely to be aged between 35 and 55 years compared to HIV seronegative patients [12/21 (57%) vs. 38/138 (28%), P=0.006]. None of the patients from the Indian Subcontinent were HIV seropositive [0/21 vs. 25/138 (18%), P=0.047]. At the present time, universal HIV testing of patients with culture-provenTB in chest clinics within the U.K. is unlikely to significantly reduce the number of patients with undiagnosed HIV.
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Affiliation(s)
- M Melzer
- Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, Middlesex, U.K
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41
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Scarparo C, Piccoli P, Rigon A, Ruggiero G, Ricordi P, Piersimoni C. Evaluation of the BACTEC MGIT 960 in comparison with BACTEC 460 TB for detection and recovery of mycobacteria from clinical specimens. Diagn Microbiol Infect Dis 2002; 44:157-61. [PMID: 12458122 DOI: 10.1016/s0732-8893(02)00437-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The BACTEC MGIT system (M960), a fully automated, non radiometric instrument, designed for rapid detection of acid fast bacilli (AFB) from clinical specimens, was compared with the radiometric BACTEC 460 system (B460) and Löwenstein-Jensen (L-J) solid medium. A total of 1,093 respiratory and extrapulmonary specimens were decontaminated by the NALC-NaOH standard method, and randomly inoculated into the media. A total of 122 mycobacteria were recovered, including 47 Mycobacterium tuberculosis complex (MTB) isolates and 75 nontuberculous mycobacteria (NTM) isolates. Overall recovery rates were 59% for M960 system (p < 0.0001), 58.2% for L-J. medium (p < 0.0001) and 82% for Bactec 460 system, whereas rates for MTB alone were 91.5, 76.6 (p = 0.007), and 95.7%, respectively. The combination of M960 or B460 systems with L-J medium showed the same recovery rates for MTB strains (97.9%), whereas NTM rates were 68% (p < 0.0001) and 93.3%, respectively. Mean time to detection of smear-positive MTB, smear-negative MTB, and NTM were 12.2, 13.4, and 23.3 days, respectively, with the M960, 11.7, 21.3, and 24.8 days with the B460 and 20.4, 28.7, and 28.4 days with L-J medium. The M960 system showed a contamination rate of 9.8%, while B460 and L-J medium showed contamination rates of 4.3 and 3.8% respectively. In conclusion, the M960 system appeared to be accurate and rapid for the recovery of MTB, but reduced recovery of NTM and a high number of contaminated cultures deserve further study in order to assess if this system can represent a valuable alternative to the radiometric system.
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Affiliation(s)
- Claudio Scarparo
- Regional Mycobacteria Reference Center, Laboratory of Clinical Microbiology and Virology, San Bortolo Hospital, Vicenza, Italy.
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Scarparo C, Piccoli P, Rigon A, Ruggiero G, Nista D, Piersimoni C. Direct identification of mycobacteria from MB/BacT alert 3D bottles: comparative evaluation of two commercial probe assays. J Clin Microbiol 2001; 39:3222-7. [PMID: 11526154 PMCID: PMC88322 DOI: 10.1128/jcm.39.9.3222-3227.2001] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The new INNO-LiPA Mycobacteria (Innogenetics, Ghent, Belgium), a reverse-hybridization-based line probe assay, and the AccuProbe assay (Gen-Probe Inc., San Diego, Calif.) were applied to MB/BacT Alert 3D (MB/BacT) system (Organon Teknika, Boxtel, The Netherlands) culture bottles and evaluated for mycobacterial identification. From 2,532 respiratory and extrapulmonary specimens submitted for culture, 168 were flagged positive by the MB/BacT system and promptly evaluated for identification (within 24 h). Each of 163 vials grew one mycobacterial isolate, including Mycobacterium tuberculosis complex (n = 73), M. avium complex (n = 3), M. avium (n = 8), M. intracellulare (n = 5), M. kansasii (n = 15), M. gordonae (n = 8), M. malmoense (n = 3), M. chelonae (n = 13), M. abscessus (n = 2), M. xenopi (n = 11), M. scrofulaceum (n = 2), M. fortuitum (n = 7), M. terrae (n = 3), M. simiae (n = 2), M. celatum (n = 3), M. flavescens (n = 1), M. interjectum (n = 1), M. bohemicum (n = 1), and M. pulveris (n = 2). Five cultures yielded mixed growth of two mycobacterial species: M. tuberculosis complex plus M. gordonae (n = 2), M. tuberculosis complex plus M. chelonae (n = 1), M. tuberculosis complex plus M. xenopi (n = 1), and M. avium plus M. chelonae (n = 1). In testing of one-isolate vials, both systems showed excellent sensitivity and specificity for all species and complexes for which they are licensed (nine for INNO-LiPA Mycobacteria versus six for AccuProbe). There were minor discrepancies in results for two isolates identified by INNO-LiPA Mycobacteria as M. avium - M. intracellulare - M. scrofulaceum (MAIS) complex and by AccuProbe as M. intracellulare. In testing of two-isolate vials, INNO-LiPA Mycobacteria correctly identified all isolates, while the AccuProbe assay failed to identify three M. tuberculosis complex isolates and one M. avium isolate. The AccuProbe assay was completed within 2 h, while INNO-LiPA Mycobacteria required a 6-h period. In our opinion, INNO-LiPA Mycobacteria offers the following advantages: (i) it contains a genus-specific probe that, in addition to being used in genus identification, may be used as an internal control for both the amplification and hybridization steps; (ii) it simultaneously identifies M. tuberculosis complex, MAIS complex, and seven other mycobacterial species, even from mixed cultures; (iii) its mycobacterial DNA amplification ensures reliable results independent from the concentration of viable microorganisms; and (iv) it genotypically identifies M. kansasii and M. chelonae. In conclusion, even though INNO-LiPA Mycobacteria is considerably less easy to use than AccuProbe, requiring personnel skilled in molecular biology techniques, it represents an excellent approach for routine identification of frequently encountered mycobacteria.
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Affiliation(s)
- C Scarparo
- Regional Mycobacteria Reference Centre, Laboratory of Clinical Microbiology and Virology, San Bortolo Hospital, Vicenza, Italy.
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