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Boldi MO, Denis-Lessard J, Neziri R, Brouillet R, von-Garnier C, Chavez V, Mazza-Stalder J, Jaton K, Greub G, Opota O. Performance of microbiological tests for tuberculosis diagnostic according to the type of respiratory specimen: A 10-year retrospective study. Front Cell Infect Microbiol 2023; 13:1131241. [PMID: 36936773 PMCID: PMC10017756 DOI: 10.3389/fcimb.2023.1131241] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/03/2023] [Indexed: 03/06/2023] Open
Abstract
Background The microbial diagnosis of tuberculosis (TB) remains challenging and relies on multiple microbiological tests performed on different clinical specimens. Polymerase chain reactions (PCRs), introduced in the last decades has had a significant impact on the diagnosis of TB. However, questions remain about the use of PCRs in combination with conventional tests for TB, namely microscopy and culture. We aimed to determine the performance of microscopy, culture and PCR for the diagnosis of pulmonary tuberculosis according to the type of clinical specimen in order to improve the diagnostic yield and to avoid unnecessary, time and labor-intensive tests. Methods We conducted a retrospective study (2008-2018) on analysis (34'429 specimens, 14'358 patients) performed in our diagnostic laboratory located in the Lausanne University Hospital to compare the performance of microbiological tests on sputum, induced sputum, bronchial aspirate and bronchoalveolar lavage (BAL). We analysed the performance using a classical "per specimen" approach and a "per patient" approach for paired specimens collected from the same patient. Results The overall sensitivities of microscopy, PCR and culture were 0.523 (0.489, 0.557), 0.798 (0.755, 0.836) and 0.988 (0.978, 0.994) and the specificity were 0.994 (0.993, 0.995), 1 (0.999, 1) and 1 (1, 1). Microscopy displayed no significant differences in sensitivity according to the type of sample. The sensitivities of PCR for sputum, induced sputum, bronchial aspirate and BAL were, 0.821 (0.762, 0.871), 0.643 (0.480, 0.784), 0.837 (0.748, 0.904) and 0.759 (0.624, 0.865) respectively and the sensitivity of culture were, 0.993 (0.981, 0.998), 0.980 (0.931, 0.998), 0.965 (0.919, 0.988), and 1 (0.961, 1) respectively. Pairwise comparison of specimens collected from the same patient reported a significantly higher sensitivity of PCR on bronchial aspirate over BAL (p < 0.001) and sputum (p < 0.05) and a significantly higher sensitivity of culture on bronchial aspirate over BAL (p < 0.0001). Conclusions PCR displayed a higher sensitivity and specificity than microscopy for all respiratory specimens, a rational for a smear-independent PCR-based approach to initiate tuberculosis microbial diagnostic. The diagnosis yield of bronchial aspirate was higher than BAL. Therefore, PCR should be systematically performed also on bronchial aspirates when available.
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Affiliation(s)
- Marc-Olivier Boldi
- Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
| | - Justin Denis-Lessard
- Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
| | - Rina Neziri
- Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
| | - René Brouillet
- Institute of Microbiology, Lausanne University and University Hospital of Lausanne, Lausanne, Switzerland
| | - Christophe von-Garnier
- Division of Pulmonology, Department of Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Valérie Chavez
- Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
| | - Jesica Mazza-Stalder
- Division of Pulmonology, Department of Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Katia Jaton
- Institute of Microbiology, Lausanne University and University Hospital of Lausanne, Lausanne, Switzerland
| | - Gilbert Greub
- Institute of Microbiology, Lausanne University and University Hospital of Lausanne, Lausanne, Switzerland
- Infectious Diseases Service, Lausanne University and University Hospital of Lausanne, Lausanne, Switzerland
| | - Onya Opota
- Institute of Microbiology, Lausanne University and University Hospital of Lausanne, Lausanne, Switzerland
- *Correspondence: Onya Opota,
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2
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Tang JW, Liu QH, Yin XC, Pan YC, Wen PB, Liu X, Kang XX, Gu B, Zhu ZB, Wang L. Comparative Analysis of Machine Learning Algorithms on Surface Enhanced Raman Spectra of Clinical Staphylococcus Species. Front Microbiol 2021; 12:696921. [PMID: 34531835 PMCID: PMC8439569 DOI: 10.3389/fmicb.2021.696921] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/30/2021] [Indexed: 12/13/2022] Open
Abstract
Raman spectroscopy (RS) is a widely used analytical technique based on the detection of molecular vibrations in a defined system, which generates Raman spectra that contain unique and highly resolved fingerprints of the system. However, the low intensity of normal Raman scattering effect greatly hinders its application. Recently, the newly emerged surface enhanced Raman spectroscopy (SERS) technique overcomes the problem by mixing metal nanoparticles such as gold and silver with samples, which greatly enhances signal intensity of Raman effects by orders of magnitudes when compared with regular RS. In clinical and research laboratories, SERS provides a great potential for fast, sensitive, label-free, and non-destructive microbial detection and identification with the assistance of appropriate machine learning (ML) algorithms. However, choosing an appropriate algorithm for a specific group of bacterial species remains challenging, because with the large volumes of data generated during SERS analysis not all algorithms could achieve a relatively high accuracy. In this study, we compared three unsupervised machine learning methods and 10 supervised machine learning methods, respectively, on 2,752 SERS spectra from 117 Staphylococcus strains belonging to nine clinically important Staphylococcus species in order to test the capacity of different machine learning methods for bacterial rapid differentiation and accurate prediction. According to the results, density-based spatial clustering of applications with noise (DBSCAN) showed the best clustering capacity (Rand index 0.9733) while convolutional neural network (CNN) topped all other supervised machine learning methods as the best model for predicting Staphylococcus species via SERS spectra (ACC 98.21%, AUC 99.93%). Taken together, this study shows that machine learning methods are capable of distinguishing closely related Staphylococcus species and therefore have great application potentials for bacterial pathogen diagnosis in clinical settings.
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Affiliation(s)
- Jia-Wei Tang
- Department of Bioinformatics, School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, China
| | - Qing-Hua Liu
- State Key Laboratory of Quality Research in Chinese Medicines, Macau University of Science and Technology, Taipa, China
| | - Xiao-Cong Yin
- Department of Laboratory Medicine, School of Medical Technology, Xuzhou Medical University, Xuzhou, China
| | - Ya-Cheng Pan
- School of Life Science, Xuzhou Medical University, Xuzhou, China
| | - Peng-Bo Wen
- Department of Bioinformatics, School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, China
| | - Xin Liu
- Department of Bioinformatics, School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, China
| | - Xing-Xing Kang
- Department of Bioinformatics, School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, China
| | - Bing Gu
- Department of Laboratory Medicine, School of Medical Technology, Xuzhou Medical University, Xuzhou, China
- Department of Laboratory Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zuo-Bin Zhu
- School of Life Science, Xuzhou Medical University, Xuzhou, China
| | - Liang Wang
- Department of Bioinformatics, School of Medical Informatics and Engineering, Xuzhou Medical University, Xuzhou, China
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, China
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3
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El-Sayyad GS, Hasan OF, Saad MAM, El-Batal AI. Improving the diagnosis of bovine tuberculosis using gold nanoparticles conjugated with purified protein derivative: special regard to staphylococcal protein A and streptococcal protein G. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:29200-29220. [PMID: 33550524 DOI: 10.1007/s11356-021-12549-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/14/2021] [Indexed: 06/12/2023]
Abstract
Different ancillary immunodiagnostic tests were traditionally-established for diagnosis of bovine tuberculosis (BTB) either cellular or humoral as tuberculin skin test (TST), gamma interferon (INF-γ), and indirect enzyme-linked immunosorbent assay (iELISA). These tests had been consumed more time and expensive, and needed sophisticated equipment. To dissolve these problems, serological diagnosis depending on humoral immunity is the aim of this work. Herein, slide-based agglutination test was chosen as a rapid and simple field test based on purified protein derivative (PPD) antigen in addition to some supplementation materials such as Staphylococcal protein A (SPA) and Streptococcal protein G (SPG) to improve detection of BTB antibody in serum samples. Gold nanoparticles (Au NPs) were synthesized by gamma ray, and after complete characterization, the synthesized Au NPs were spherical, small-sized, and stable without any impurities. Addition of such supplementation reagents for serodiagnosis of tuberculosis is of paramount important for the detection of serum antibodies against tuberculosis (TB) and it was considered an easily simple and possible way for improving TB diagnosis. In this work, 70 animals tested positive for TST as well as 20 animals tested negative for TST were used for the diagnosis of BTB depending on humoral immune response based on PPD slide agglutination test using reporter regents (SPA and/or SPG) either native or recombinant. The agglutination density was recorded and read in 4 degrees of positivity with scores ranging from negative (-) to very strong reaction (++++) occurred in different times of agglutination. Groups showed 100% positive reactivates employed in Exp. 1, 2, and 3 with differentiation of slide agglutination test density and was rated from moderate positivity (2+) to very strong (4+), with predominant positivity in density of (3+). Pink-colored intensity is associated with the strengthened reactions between PPD-conjugated Au NPs and serum antibody of each tested samples, which allows for visual rapid, simple, and effective attractive diagnosis of BTB. The specificity and sensitivity of the serological tests were characterized. TST offers the highest sensitivity (83.6%) among the other immunoassays, while the lowest specificity was recorded in TST (57.4%). SPA/SPG offers the best performance in term of combined sensitivity and specificity (performance index) of 175.4. Therefore, the development and uses of detection reagent (such as SPA and/or SPG) slide co-agglutination test (COAT), either native or recombinant (rSPA/SPG) for the detection of TB antibodies based on PPD antigen, as well as the uses of Au NPs rSPA/SPG as detection conjugate based on the same antigen, were also performed as a simple, rapid, sensitive, specific, eco-friendly, and low cost, which shows a great potential in field and lab diagnosis of BTB. So, high reduction in reagents that yields reactions similarly as traditional techniques was needed.
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Affiliation(s)
- Gharieb S El-Sayyad
- Drug Microbiology Lab., Drug Radiation Research Department, National Center for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority (EAEA), Cairo, Egypt.
| | - Omnia F Hasan
- Animal Health Research Institute, Bacteriology Department, TB Unit, Dokki, Giza, Egypt
| | | | - Ahmed I El-Batal
- Drug Microbiology Lab., Drug Radiation Research Department, National Center for Radiation Research and Technology (NCRRT), Egyptian Atomic Energy Authority (EAEA), Cairo, Egypt
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4
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Optimization of Lyophilized LAMP and RT-PCR Reaction Mixes for Detection of Tuberculosis. THE EUROBIOTECH JOURNAL 2020. [DOI: 10.2478/ebtj-2020-0027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Undoubtedly, one of the most infectious diseases in the world is tuberculosis. Key factor for tuberculosis control is to prevent possible contagion with rapid diagnosis and effective treatment. The culture method, which it takes several weeks to obtain results, is the gold standard method for laboratory diagnosis of tuberculosis. In order to prevent possible contagion of tuberculosis, diagnosis must be made in short time and treatment should be started as soon as possible. Normally, clinical samples are studied in advanced laboratories designed for this purpose. However, especially after the screening in rural areas, the transmission of the samples to the centers has many negative effects on the clinical material. Therefore, the latest trend molecular techniques in microbiological diagnosis are developing into point of care systems that can be applied in the field without laboratory infrastructure. The major challenge for molecular-based point-of-care tests is the need to store polymerase enzymes and some of the ingredients used in the cold chain. The aim of this study is to increase the resistance of the amplification reaction mixtures by lyophilizing the tuberculosis diagnosis. Lyophilization was performed on Loop-mediated isothermal amplification (LAMP) and Real-time PCR mixtures. For the lyophilization of LAMP and RT-PCR mixtures, two different experimental setups were tried from the literature except for the developed content. Chemicals such as stachyose, trehalose, glycerol and PEG 8000 are widely using as cryoprotectants. As a result, the developed content (0.5% PEG 8000, 2.0 % Stachyose) was determined the best cryoprotectant mixture. Accordingly, amplification mixtures can be produced with the developed lyophilization method and point of care kits can be developed.
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5
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Salimiyan Rizi K, Aryan E, Meshkat Z, Ranjbar G, Sankian M, Ghazvini K, Farsiani H, Pourianfar HR, Rezayi M. The overview and perspectives of biosensors and Mycobacterium tuberculosis: A systematic review. J Cell Physiol 2020; 236:1730-1750. [PMID: 32930412 DOI: 10.1002/jcp.30007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 08/01/2020] [Indexed: 12/14/2022]
Abstract
Tuberculosis (TB) is referred to as a "consumption" or phthisis, which has been a fatal human disease for thousands of years. Mycobacterium tuberculosis (M. tb) might have been responsible for the death of more humans than any other bacterial pathogens. Therefore, the rapid diagnosis of this bacterial infection plays a pivotal role in the timely and appropriate treatment of the patients, as well as the prevention of disease spread. More than 98% of TB cases are reported in developing countries, and due to the lack of well-equipped and specialized diagnostic laboratories, development of effective diagnostic methods based on biosensors is essential for this bacterium. In this review, original articles published in English were retrieved from multiple databases, such as PubMed, Scopus, Google Scholar, Science Direct, and Cochrane Library during January 2010-October 2019. In addition, the reference lists of the articles were also searched. Among 109 electronically searched citations, 42 articles met the inclusion criteria. The highest potential and wide usage of biosensors for the diagnosis of M. tb and its drug resistance belonged to DNA electrochemical biosensors (isoniazid and rifampin strains). Use of biosensors is expanding for the detection of resistant strains of anti-TB antibiotics with high sensitivity and accuracy, while the speed of these sensory methods is considered essential as well. Furthermore, the lowest limit of detection (0.9 fg/ml) from an electrochemical DNA biosensor was based on graphene-modified iron-oxide chitosan hybrid deposited on fluorine tin oxide for the MPT64 antigen target. According to the results, the most common methods used for M. tb detection include acid-fast staining, cultivation, and polymerase chain reaction (PCR). Although molecular techniques (e.g., PCR and real-time PCR) are rapid and sensitive, they require sophisticated laboratory and apparatuses, as well as skilled personnel and expertise in the commentary of the results. Biosensors are fast, valid, and cost-efficient diagnostic method, and the improvement of their quality is of paramount importance in resource-constrained settings.
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Affiliation(s)
- Kobra Salimiyan Rizi
- Department of Medical Bacteriology and Virology, School of Medicine, Antimicrobial Resistance Research Center, Qaem University Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Aryan
- Department of Medical Bacteriology and Virology, School of Medicine, Antimicrobial Resistance Research Center, Qaem University Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Meshkat
- Department of Medical Bacteriology and Virology, School of Medicine, Antimicrobial Resistance Research Center, Qaem University Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Golnaz Ranjbar
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Sankian
- Division of Immunobiochemistry, Immunology Research Centre, Bu-Ali Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kiarash Ghazvini
- Department of Medical Bacteriology and Virology, School of Medicine, Antimicrobial Resistance Research Center, Qaem University Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Farsiani
- Department of Medical Bacteriology and Virology, School of Medicine, Antimicrobial Resistance Research Center, Qaem University Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid R Pourianfar
- Research Department of Industrial Fungi Biotechnology, Research Institute for Industrial Biotechnology, Academic Centre for Education, Culture and Research [ACECR]-Khorasan Razavi Province Branch, Mashhad, Iran
| | - Majid Rezayi
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Medical Biotechnology and Nanotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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6
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Chu ZJ, Xiao SJ, Yuan MY, Wang LZ, Wang SP, Zhang GM, Zhang ZB. Rapid and sensitive detection of Mycobacterium tuberculosis based on strand displacement amplification and magnetic beads. LUMINESCENCE 2020; 36:66-72. [PMID: 32706457 DOI: 10.1002/bio.3918] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/06/2020] [Accepted: 07/16/2020] [Indexed: 11/10/2022]
Abstract
Tuberculosis is one of the main infectious diseases threatening public health, and the development of simple, rapid, and cost-saving methods for tuberculosis diagnosis is of profound importance for tuberculosis prevention and treatment. The bacterium Mycobacterium tuberculosis (MTB) is the pathogen that causes tuberculosis, and assaying for MTB is the only criterion for tuberculosis diagnosis. A new enzyme-free method based on strand displacement amplification and magnetic beads was developed for simple, rapid, and cost-saving MTB detection. Under optimum conditions, a good linear relationship could be observed between fluorescence and MTB specific DNA concentration ranging from 0.05 to 150 nM with a correlation coefficient of 0.993 (n = 8) and a detection limit of 47 pM (3σ/K). The present method also distinguished a one base mismatch from MTB specific DNA, showing great promise for MTB genome single base polymorphism analysis. MTB specific DNA content in polymerase chain reaction samples was successfully detected using the new method, and recoveries were 97.8-100.8%, indicating that the present method had high accuracy and shows good potential for the early diagnosis of tuberculosis.
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Affiliation(s)
- Zhao Jun Chu
- Fundamental Science on Radioactive Geology and Exploration Technology Laboratory, East China University of Technology, Nanchang, China
| | - Sai Jin Xiao
- Fundamental Science on Radioactive Geology and Exploration Technology Laboratory, East China University of Technology, Nanchang, China.,School of Chemistry, Biology and Material Science, ECUT, Nanchang, China
| | - Ming Yue Yuan
- School of Chemistry, Biology and Material Science, ECUT, Nanchang, China
| | - Li Zhi Wang
- School of Chemistry, Biology and Material Science, ECUT, Nanchang, China
| | - Shan Ping Wang
- School of Chemistry, Biology and Material Science, ECUT, Nanchang, China
| | - Guang Mei Zhang
- School of Chemistry, Biology and Material Science, ECUT, Nanchang, China
| | - Zhi Bin Zhang
- School of Chemistry, Biology and Material Science, ECUT, Nanchang, China
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7
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Gómez-Tangarife VJ, Gómez-Restrepo AJ, Robledo-Restrepo J, Hernández-Sarmiento JM. [Drug resistance in Mycobacterium tuberculosis: contribution of constituent and acquired mechanisms]. ACTA ACUST UNITED AC 2019; 20:491-497. [PMID: 30843986 DOI: 10.15446/rsap.v20n4.50575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 02/12/2018] [Indexed: 11/09/2022]
Abstract
Due to the emergence of multi-drug resistant (MDR-MTB) and extensively drug-resistant (XDR-MTB) Mycobacterium tuberculosis (MTB) isolates, the failure rates of standard treatment regimens are high, thus becoming a major public health challenge worldwide. Resistance to anti-tuberculous (anti-TB) drugs is attributed mainly to specific mutations in target genes; however, a proportion of drug-resistant MTB isolates do not have mutations in these genes, which suggests the involvement of other mechanisms, such as the low permeability of the mycobacterial cell wall, enzymatic modification and/or efflux pumps. Clinical drug resistance to anti-TB drugs occurs largely as a result of the selection of resistant mutants caused by poor patient adherence to treatment, inappropriate follow-ups and prescriptions, suboptimal doses of drugs and poor access to health services and treatment. Major advances in molecular biology tools and the availability of the complete genome sequences of MTB have contributed to improve understanding of the mechanisms of resistance to the main anti-TB drugs. Better knowledge of the drug-resistance of MTB will contribute to the identification of new therapeutic targets to design new drugs, develop new diagnostic tests and/or improve methods currently available for the rapid detection of drug-resistant TB. This article presents an updated review of the mechanisms and molecular basis of drug resistance in MTB.
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Affiliation(s)
- Verónica J Gómez-Tangarife
- VG: Bacterióloga y Laboratorista. Clínico. M. Sc. Ciencias Médicas -Microbiología Corporación para Investigaciones Biológicas. Medellín, Colombia.
| | - Alex J Gómez-Restrepo
- AG: Bibliotecólogo. M. Sc. Bibliotecología y Ciencias de la Información, Medellín, Colombia. Institución: Corporación para Investigaciones Biológicas.
| | - Jaime Robledo-Restrepo
- JR: MD. Ph. D. Ciencias Médicas. - Microbiología, Institución: Universidad Pontificia Bolivariana y Corporación para Investigaciones Biológicas. Medellín, Colombia.
| | - José M Hernández-Sarmiento
- JH: MD. M. Sc.; Ph. D. Ciencias Médicas - Microbiología., Institución: Universidad Pontificia Bolivariana. Medellín, Colombia.
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Wei Z, Zhang X, Wei C, Yao L, Li Y, Zhang X, Xu H, Jia Y, Guo R, Wu Y, Yang K, Gao X. Diagnostic accuracy of in-house real-time PCR assay for Mycobacterium tuberculosis: a systematic review and meta-analysis. BMC Infect Dis 2019; 19:701. [PMID: 31395014 PMCID: PMC6686366 DOI: 10.1186/s12879-019-4273-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 07/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years, studies on the diagnostic accuracy of in-house real-time PCR (hRT-PCR) assay for the detection of Mycobacterium tuberculosis (Mtb) have been reported with unignorable discrepancies. To assess the overall accuracy of the hRT-PCR assay for Mtb diagnosis in different samples for individuals with active pulmonary and extra-pulmonary Mtb infection, a systematic review and meta-analysis were performed. METHODS The PUBMED, EMBASE, Web of Science, and Cochrane databases were searched up to June 2017 for eligible studies that estimated diagnostic sensitivity and specificity with the hRT-PCR assay in respiratory and non-respiratory samples in pulmonary and extra-pulmonary Mtb infection patients, with Mtb culture as the reference standard. Bivariate random effect models were used to provide pooled estimation of diagnostic accuracy. Further, subgroup and meta-regression analyses were performed to explore sources of heterogeneity. The risk of bias was assessed by the QUADAS-2 tool. RESULTS Of the 3589 candidate studies, 18 eligible studies met our inclusion criteria. Compared to Mtb culture data, the pooled sensitivity and specificity were 0.96 and 0.92, respectively. The diagnostic odds ratio (DOR) was 192.96 (95% CI 68.46, 543.90), and the area under the summary ROC curve (AUC) was 0.9791. There was significant heterogeneity in sensitivity and specificity among the enrolled studies (p < 0.001). The studies with high-quality assessment and application of respiratory specimen were associated with better accuracy. CONCLUSIONS In low-income/high-burden settings, our results suggested that the hRT-PCR assay could be a useful test for the diagnosis of TB with high sensitivity and specificity.
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Affiliation(s)
- Zhenhong Wei
- Blood Transfusion Department, Gansu Provincial Hospital, Lanzhou, 730000, Gansu, China
| | - Xiaoping Zhang
- Blood Transfusion Department, Gansu Provincial Hospital, Lanzhou, 730000, Gansu, China
| | - Chaojun Wei
- The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, No. 204, Donggang street, Chengguan district, Lanzhou, 730000, Gansu, China
| | - Liang Yao
- The Institute of Clinical Study and Evidence-Based Medicine, Gansu Provincial Hospital, Lanzhou, 730000, Gansu, China.,Evidence-Based Medicine Center and Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, College of Basic Medicine, Lanzhou University, No. 199, Donggang street, Chengguan district, Lanzhou, 73000, Gansu, China
| | - Yonghong Li
- The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, No. 204, Donggang street, Chengguan district, Lanzhou, 730000, Gansu, China
| | - Xiaojing Zhang
- Blood Transfusion Department, Gansu Provincial Hospital, Lanzhou, 730000, Gansu, China
| | - Hui Xu
- The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, No. 204, Donggang street, Chengguan district, Lanzhou, 730000, Gansu, China
| | - Yanjuan Jia
- The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, No. 204, Donggang street, Chengguan district, Lanzhou, 730000, Gansu, China
| | - Rui Guo
- The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, No. 204, Donggang street, Chengguan district, Lanzhou, 730000, Gansu, China
| | - Yu Wu
- The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, No. 204, Donggang street, Chengguan district, Lanzhou, 730000, Gansu, China
| | - Kehu Yang
- The Institute of Clinical Study and Evidence-Based Medicine, Gansu Provincial Hospital, Lanzhou, 730000, Gansu, China. .,Evidence-Based Medicine Center and Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, College of Basic Medicine, Lanzhou University, No. 199, Donggang street, Chengguan district, Lanzhou, 73000, Gansu, China.
| | - Xiaoling Gao
- The Institute of Clinical Research and Translational Medicine, Gansu Provincial Hospital, No. 204, Donggang street, Chengguan district, Lanzhou, 730000, Gansu, China.
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Ngema XT, Baker P, Ajayi F, Aubert PH, Banet P. Polyamic acid (PAA) immobilized on glassy carbon electrode (GCE) as an electrochemical platform for the sensing of tuberculosis (TB) antibodies and hydrogen peroxide determination. ANAL LETT 2019. [DOI: 10.1080/00032719.2019.1636058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Xolani Terrance Ngema
- SensorLab, Department of Chemistry, University of the Western Cape, Bellville, South Africa
- Laboratoire de Physico-chimie des Polymères et des Interfaces (LPPI, EA 2528), Université de Cergy-Pontoise, Neuville-sur-Oise, France
| | - Priscilla Baker
- SensorLab, Department of Chemistry, University of the Western Cape, Bellville, South Africa
| | - Fanelwa Ajayi
- SensorLab, Department of Chemistry, University of the Western Cape, Bellville, South Africa
| | - Pierre-Henri Aubert
- Laboratoire de Physico-chimie des Polymères et des Interfaces (LPPI, EA 2528), Université de Cergy-Pontoise, Neuville-sur-Oise, France
| | - Philippe Banet
- Laboratoire de Physico-chimie des Polymères et des Interfaces (LPPI, EA 2528), Université de Cergy-Pontoise, Neuville-sur-Oise, France
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10
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Shibabaw A, Gelaw B, Kelley H, Balada-Llasat JM, Evans C, Wang SH, Torrelles JB, Tessema B. Accuracy of the color plate micro-colony detection for the diagnosis of Mycobacterium tuberculosis complex in Northwest Ethiopia. Tuberculosis (Edinb) 2019; 114:54-60. [PMID: 30711158 DOI: 10.1016/j.tube.2018.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 11/18/2018] [Accepted: 11/25/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Accurate and timely tuberculosis diagnosis is the primary step for initiating effective treatment. The color plate agar-based culture test (TB-CX test) is low cost, simple to use and detects Mycobacterium tuberculosis faster. Therefore, the main objective of this study was to compare the diagnostic accuracy and time to detection of positive cultures using color test and Lӧwenstein Jensen culture. METHODS A comparative cross-sectional study was conducted at University of Gondar Hospital. A total of 200 sputum samples were collected from TB patients and processed for direct smear microscopy and cultures. RESULTS Sixty-five percent were found positive on both methods and 4 (2%) were positive on LJ culture and negative on the color plate. The median time for detection of MTB growth was significantly shorter using color plate test (Median 12 days) than LJ culture (Median 21 days) (P < 0.0001). The overall sensitivity and specificity of the color test compared to LJ culture were 97% (95% CI: 93-99) and 100% (95% CI: 94-100), respectively. CONCLUSIONS The color plate test for micro-colonies allows early and accurate MTB diagnosis in a median time of 12 days. This rapid method could be an option for diagnosis of pulmonary TB in resource limited settings.
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Affiliation(s)
- Agumas Shibabaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Baye Gelaw
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Holden Kelley
- Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA
| | | | - Carlton Evans
- The Wellcome Centre for Clinical Tropical Medicine, Imperial College of London, London, United Kingdom
| | - Shu-Hua Wang
- Department of Internal Medicine, Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, OH, USA
| | | | - Belay Tessema
- Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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11
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Kolia-Diafouka P, Godreuil S, Bourdin A, Carrère-Kremer S, Kremer L, Van de Perre P, Tuaillon E. Optimized Lysis-Extraction Method Combined With IS6110-Amplification for Detection of Mycobacterium tuberculosis in Paucibacillary Sputum Specimens. Front Microbiol 2018; 9:2224. [PMID: 30319564 PMCID: PMC6167964 DOI: 10.3389/fmicb.2018.02224] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 08/31/2018] [Indexed: 01/21/2023] Open
Abstract
Background: When available, nucleic acid tests (NATs) offer powerful tools to strengthen the potential of tuberculosis (TB) diagnosis assays. The sensitivity of molecular assays is critical for detection of Mycobacterium tuberculosis (MTB) in paucibacillary sputum. Materials and Methods: The impact of targeting repetitive IS6110 sequences on the PCR sensitivity was evaluated across mycobacterium strains and reference material. Six lysis-extraction protocols were compared. Next, 92 clinical sputum specimens including 62 culture-positive samples were tested and the results were compared to sputum-smear microscopy, culture, and Xpert MTB/RIF test. Finally, the capacity to detect low MTB DNA concentrations was assessed in 40 samples containing <1.5 × 102 copies/ml ex vivo or after dilution. Results: The lower limit of detection (LOD) using the IS6110 PCR was 107 genome copies/ml (95% CI: 83–130) using MTB H37Rv as a reference strain, versus 741 genome copies/ml (95% CI: 575–1094) using the senX3 PCR. The proportion of recovered MTB DNA after lysis and extraction ranged from 35 to 82%. The Chelex® method appeared as a more efficient protocol among the six different protocols tested. The sensitivity and specificity in clinical sputum samples were 95.1% (95% CI: 90.7–99.6) and 100% (95% CI: 96.2–100.8), respectively. Among 40 samples with low MTB DNA concentration, 75% tested positive for IS6110 PCR, versus 55% using the Xpert MTB/RIF assay (p = 0.03). Conclusion: Laboratory assays based on an efficient MTB lysis and DNA extraction protocols combined with amplification of IS6110 repeat sequences appear as a sensitive diagnostic method to detect MTB DNA in sputum with low bacterial load.
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Affiliation(s)
- Pratt Kolia-Diafouka
- Pathogenesis and Control of Chronic Infections, INSERM, EFS, Université de Montpellier, Montpellier, France
| | - Sylvain Godreuil
- UMR MIVEGEC IRD-CNRS-Université de Montpellier, Montpellier, France
| | - Arnaud Bourdin
- PhyMedExp, INSERM U1046, CNRS UMR 9214, Centre Hospitalier Régional Universitaire de Montpellier, Université de Montpellier, Montpellier, France
| | - Severine Carrère-Kremer
- Pathogenesis and Control of Chronic Infections, INSERM, EFS, Université de Montpellier, Montpellier, France
| | - Laurent Kremer
- Centre National de la Recherche Scientifique, UMR 9004, Institut de Recherche en Infectiologie de Montpellier, Montpellier, France
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infections, INSERM, EFS, Université de Montpellier, Montpellier, France
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic Infections, INSERM, EFS, Université de Montpellier, Montpellier, France
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12
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Song N, Tan Y, Zhang L, Luo W, Guan Q, Yan MZ, Zuo R, Liu W, Luo FL, Zhang XL. Detection of circulating Mycobacterium tuberculosis-specific DNA by droplet digital PCR for vaccine evaluation in challenged monkeys and TB diagnosis. Emerg Microbes Infect 2018; 7:78. [PMID: 29691363 PMCID: PMC5915492 DOI: 10.1038/s41426-018-0076-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 03/02/2018] [Accepted: 03/05/2018] [Indexed: 12/29/2022]
Abstract
Mycobacterium tuberculosis (M. tb) is emerging as a more serious pathogen due to the increased multidrug-resistant TB and co-infection of human immunodeficiency virus (HIV). The development of an effective and sensitive detection method is urgently needed for bacterial load evaluation in vaccine development, early TB diagnosis, and TB treatment. Droplet digital polymerase chain reaction (ddPCR) is a newly developed sensitive PCR method for the absolute quantification of nucleic acid concentrations. Here, we used ddPCR to quantify the circulating virulent M. tb-specific CFP10 (10-kDa culture filtrate protein, Rv3874) and Rv1768 DNA copy numbers in the blood samples from Bacille Calmette-Guerin (BCG)-vaccinated and/or virulent M. tb H37Rv-challenged rhesus monkeys. We found that ddPCR was more sensitive compared to real-time fluorescence quantitative PCR (qPCR), as the detection limits of CFP10 were 1.2 copies/μl for ddPCR, but 15.8 copies/μl for qPCR. We demonstrated that ddPCR could detect CFP10 and Rv1768 DNA after 3 weeks of infection and at least two weeks earlier than qPCR in M.tb H37Rv-challenged rhesus monkey models. DdPCR could also successfully quantify CFP10 and Rv1768 DNA copy numbers in clinical TB patients’ blood samples (active pulmonary TB, extrapulmonary TB (EPTB), and infant TB). To our knowledge, this study is the first to demonstrate that ddPCR is an effective and sensitive method of measuring the circulating CFP10 and Rv1768 DNA for vaccine development, bacterial load evaluation in vivo, and early TB (including EPTB and infant TB) diagnosis as well.
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Affiliation(s)
- Neng Song
- State Key Laboratory of Virology and Medical Research Institute, Hubei Province Key Laboratory of Allergy and Immunology and Department of Immunology, Wuhan University School of Basic Medical Sciences, Wuhan, 430071, China
| | - Yang Tan
- State Key Laboratory of Virology and Medical Research Institute, Hubei Province Key Laboratory of Allergy and Immunology and Department of Immunology, Wuhan University School of Basic Medical Sciences, Wuhan, 430071, China
| | - Lingyun Zhang
- State Key Laboratory of Virology and Medical Research Institute, Hubei Province Key Laboratory of Allergy and Immunology and Department of Immunology, Wuhan University School of Basic Medical Sciences, Wuhan, 430071, China
| | - Wei Luo
- State Key Laboratory of Virology and Medical Research Institute, Hubei Province Key Laboratory of Allergy and Immunology and Department of Immunology, Wuhan University School of Basic Medical Sciences, Wuhan, 430071, China
| | - Qing Guan
- State Key Laboratory of Virology and Medical Research Institute, Hubei Province Key Laboratory of Allergy and Immunology and Department of Immunology, Wuhan University School of Basic Medical Sciences, Wuhan, 430071, China
| | - Ming-Zhe Yan
- Wuhan Medical Treatment Center, Wuhan, 430071, China
| | - Ruiqi Zuo
- State Key Laboratory of Virology and Medical Research Institute, Hubei Province Key Laboratory of Allergy and Immunology and Department of Immunology, Wuhan University School of Basic Medical Sciences, Wuhan, 430071, China
| | - Weixiang Liu
- State Key Laboratory of Virology and Medical Research Institute, Hubei Province Key Laboratory of Allergy and Immunology and Department of Immunology, Wuhan University School of Basic Medical Sciences, Wuhan, 430071, China
| | - Feng-Ling Luo
- State Key Laboratory of Virology and Medical Research Institute, Hubei Province Key Laboratory of Allergy and Immunology and Department of Immunology, Wuhan University School of Basic Medical Sciences, Wuhan, 430071, China.
| | - Xiao-Lian Zhang
- State Key Laboratory of Virology and Medical Research Institute, Hubei Province Key Laboratory of Allergy and Immunology and Department of Immunology, Wuhan University School of Basic Medical Sciences, Wuhan, 430071, China.
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13
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Prasad R, Singh A, Balasubramanian V, Gupta N. Extensively drug-resistant tuberculosis in India: Current evidence on diagnosis & management. Indian J Med Res 2018; 145:271-293. [PMID: 28749390 PMCID: PMC5555056 DOI: 10.4103/ijmr.ijmr_177_16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Emergence of extensively drug-resistant tuberculosis (XDR-TB) has significantly threatened to jeopardize global efforts to control TB, especially in HIV endemic regions. XDR-TB is mainly an iatrogenically created issue, and understanding the epidemiological and risk factors associated with it is of paramount importance in curbing this menace. Emergence of this deadly phenomenon can be prevented by prompt diagnosis and effective treatment with second-line drugs in rifampicin-resistant TB (RR-TB) as well as multidrug-resistant TB (MDR-TB) patients. Optimal treatment of RR-TB, MDR-TB and XDR-TB cases alone will not suffice to reduce the global burden. The TB control programmes need to prioritize on policies focusing on the effective as well as rational use of first-line drugs in every newly diagnosed drug susceptible TB patients so as to prevent the emergence of drug resistance.
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Affiliation(s)
- Rajendra Prasad
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, India
| | - Abhijeet Singh
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, India
| | | | - Nikhil Gupta
- Department of Medicine, Era's Medical College, Lucknow, India
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Azadi D, Motallebirad T, Ghaffari K, Shojaei H. Mycobacteriosis and Tuberculosis: Laboratory Diagnosis. Open Microbiol J 2018; 12:41-58. [PMID: 29785215 PMCID: PMC5897959 DOI: 10.2174/1874285801812010041] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/11/2018] [Accepted: 03/15/2018] [Indexed: 12/22/2022] Open
Abstract
Background Tuberculosis is one of the most important infectious diseases that has claimed its victims throughout much of known human history. With Koch's discovery of the tubercle bacillus as the etiologic agent of the disease, his sanitary and hygienic measures, which were based on his discovery and the development of a vaccine against tuberculosis by Albert Calmette and Camille Guérin in 1921, an attenuated Mycobacterium bovis strain, bacilli Calmette-Guérin (BCG), and the discovery of the first antibiotic against tuberculosis, streptomycin by Selman Waksman in 1943, soon led to the opinion that appropriate control measures had become available for tuberculosis and it had been assumed that the disease could ultimately be eradicated.The emergence of resistant strains of this bacteria and widespread distribution of the disease in the world, and the emergence of the AIDS epidemic destroyed any possibility of global control of tuberculosis in the foreseeable future. Objectives The purpose of this review is to highlight the current scientific literature on mycobacterial infections and provide an overview on the laboratory diagnosis of tuberculosis and non-tuberculosis infections based on conventional phenotypic and modern molecular assays. Method In this study, a number of 65 papers comprising 20 reviews, 9 case reports, and 36 original research in association with mycobacteriosis and the laboratory diagnosis of mycobacterial infections, were reviewed. Results Based on our analysis on the published documents methods applied for the laboratory diagnosis of tuberculosis are continually assessed and developed in order to achieve more rapid, less expensive, and accurate results. Acid-fast staining and culture for mycobacteria remain at the core of any diagnostic algorithm with the sensitivity of 20-70% and specificity of 95-98% for AFB microscopy and the sensitivity of 95% and the specificity of 98% for culture based diagnosis. Following growth in culture, molecular tests such as nucleic acid hybridization probes and DNA sequencing may be used for definitive species identification. Nucleic acid amplification methods provide the means for direct detection of Mycobacterium tuberculosis in respiratory specimens without the prerequisite to isolate or culture the organism, leading to more rapid diagnosis and better patient care. Conclusion As the researchers in a developing country, we strongly believe that despite significant advances in laboratory capacity, in many countries reliable confirmation of suspected mycobacterial diseases is hindered by a lack of knowledge on proper standardized methods, sufficient funds, suitably trained staff and laboratory supplies.
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Affiliation(s)
- Davood Azadi
- Department of Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran
| | - Tahereh Motallebirad
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan Iran
| | - Kazem Ghaffari
- Department of Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran
| | - Hasan Shojaei
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan Iran
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15
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Nambiar R, Chatellier S, Bereksi N, van Belkum A, Singh N, Barua B, Shetty A, Rodrigues C. Evaluation of Mycotube, a modified version of Lowenstein-Jensen (LJ) medium, for efficient recovery of Mycobacterium tuberculosis (MTB). Eur J Clin Microbiol Infect Dis 2017; 36:1981-1988. [PMID: 28685188 DOI: 10.1007/s10096-017-3052-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 06/20/2017] [Indexed: 12/01/2022]
Abstract
Timely diagnosis of tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), is only achieved for ~58% cases. An improved, accurate, time- and cost-effective method for bacteriological confirmation of MTB is necessary. We evaluated Mycotube, a new variant of Lowenstein-Jensen (LJ) culture medium, by comparing it with Mycobacterium Growth Indicator Tube (MGIT) 960 (gold standard), local LJ, and bioMérieux LJ-T in terms of isolation rate and time-to-growth. Pulmonary and extra-pulmonary samples from treatment-naïve suspects (n = 207) were decontaminated by the N-acetyl-L-cysteine-sodium hydroxide method and used to inoculate the four media. Subjective and objective parameters were used for evaluation. Mycotube yielded 140 positive results, compared to 162, 69, and 141 from MGIT, local LJ, and LJ-T, respectively. Of these, 139 (67%) were true-positive results and 1 (0.5%) was false-positive. The mean time-to-growth detection was 17.4 days for Mycotube, compared to 14.5, 28.1, and 16.5 days for MGIT, local LJ, and LJ-T, respectively. The mean time-to-growth for local LJ significantly differed from that for MGIT, but not those for LJ-T and Mycotube. No contamination was observed. Mycotube had a sensitivity of 85.8% and a specificity of 97.8% as compared to MGIT. Mycotube offers good results, comparable with those observed for conventional LJ. It requires only basic laboratory infrastructure. The overall cost of the test should be nearly three times lower than that of MGIT. Mycotube helps with TB diagnosis and generates pure isolates for drug susceptibility testing.
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Affiliation(s)
- R Nambiar
- Section of Microbiology, Department of Laboratory Medicine, PD Hinduja Hospital and Medical Research Centre, Mumbai, India.
| | - S Chatellier
- bioMérieux, 3 route de Port Michaud, 38390, La Balme Les Grottes, France
| | - N Bereksi
- bioMérieux, ZA des Lilas, 5 rue des Aqueducs, BP 10, 69290, Craponne, France
| | - A van Belkum
- bioMérieux, 3 route de Port Michaud, 38390, La Balme Les Grottes, France
| | - N Singh
- bioMérieux India Private Limited, New Delhi, India
| | - B Barua
- bioMérieux India Private Limited, New Delhi, India
| | - A Shetty
- Section of Microbiology, Department of Laboratory Medicine, PD Hinduja Hospital and Medical Research Centre, Mumbai, India
| | - C Rodrigues
- Section of Microbiology, Department of Laboratory Medicine, PD Hinduja Hospital and Medical Research Centre, Mumbai, India
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Iskandar A, Nursiloningrum E, Arthamin MZ, Olivianto E, Chandrakusuma MS. The Diagnostic Value of Urine Lipoarabinomannan (LAM) Antigen in Childhood Tuberculosis. J Clin Diagn Res 2017; 11:EC32-EC35. [PMID: 28511392 PMCID: PMC5427318 DOI: 10.7860/jcdr/2017/20909.9542] [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: 07/16/2016] [Accepted: 12/06/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Diagnosis of Tuberculosis (TB) in children is difficult because the clinical presentation is not specific, the chest X-ray interpretation has low accuracy and sputum sample is difficult to obtain. Antigen detection test such as rapid urine LAM is a non-invasive alternative for diagnosing TB . Lipoarabinomannan (LAM) is the main component of M.tuberculosis cell wall. AIM To determine the diagnostic value of urinary LAM antigen for diagnosis of childhood TB. MATERIALS AND METHODS In the present cross-sectional study, subjects were included using consecutive sampling method. All the children aged 0-14 years Suspected of pulmonary or extra pulmonary TB suffering from cough more than two weeks, fever without clear aetiology, loss of body weight or poor weight gain, fatigue, malaise, chronic lymph node enlargement, spine angulation, joint swelling and had history of contact with positive sputum smear adult TB patient were enrolled in the study. Pulmonary and extra pulmonary diagnosis was based on clinical presentation, Tuberculin Skin Test (TST), chest X-ray, Acid Fast Bacillus (AFB) staining and or sputum culture. Urinary LAM level was measured by using Enzyme-Linked Immunosorbent Assay (ELISA). Cut off value and Area Under the Curve (AUC) were determined using ROC statistical analysis (SPSS 21.0). Sensitivity and specificity was measured from 2x2 cross table. RESULTS Out of 61 subjects suspected as TB, 49 (80.3%) were eventually diagnosed with TB. Of those diagnosed with TB, 21 (42.9%) were microbiologically confirmed cases either by sputum microscopy (34.7%) or culture (8.2%), whereas 28 subjects were unconfirmed cases (57.1%). The urinary LAM level was higher in subjects with TB (1.80+1.02) mg/l compared to non-TB group (0.46+0.3) mg/l; p<0.001(independent t-test). Urine LAM had 83% sensitivity and 85% specificity with cut off value 0.98 mg/l using microbiological and clinical confirmation as standard reference and 33% sensitivity and 60% specificity with cut off value 1.69 mg/l using microbiological confirmation only. CONCLUSION Urinary LAM has good diagnostic value for childhood TB diagnosis.
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Affiliation(s)
- Agustin Iskandar
- Consultant, Department of Clinical Pathology, Universitas Brawijaya, Malang, East Java, Indonesia
| | - Erlin Nursiloningrum
- Consultant, Department of Clinical Pathology, Universitas Brawijaya, Malang, East Java, Indonesia
| | | | - Ery Olivianto
- Consultant, Department of Child Health, Universitas Brawijaya, Malang, East Java, Indonesia
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Mavenyengwa RT, Shaduka E, Maposa I. Evaluation of the Xpert® MTB/RIF assay and microscopy for the diagnosis of Mycobacterium tuberculosis in Namibia. Infect Dis Poverty 2017; 6:13. [PMID: 28086955 PMCID: PMC5237317 DOI: 10.1186/s40249-016-0213-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 12/09/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) kills approximately two million people and infects around nine million worldwide annually. Its proper management, especially in resource-limited settings, has been hindered by the lack of rapid and easy-to-use diagnostic tests. Sputum smear microscopy remains the cheapest, readily available diagnostic method but it only identifies less than half of the patients with a HIV/TB co-infection because the bacilli would have disseminated from the lungs to other areas of the body. The fully automated Xpert® MTB/RIF assay is a promising innovation for diagnosing TB and detecting resistance to rifampicin. This study aimed to evaluate the use of Xpert® MTB/RIF assay and microscopy in the diagnosis of Mycobacterium tuberculosis in Namibia, by determining the disease's epidemiology and calculating the proportion of cases infected just with TB and those with a resistance to rifampicin among the total suspected cases of TB in the country. METHODS This retrospective study analysed TB cases that were diagnosed using both the Xpert® MTB/RIF assay and microscopy. Data were collected from patient records from the Meditech laboratory information system of the Namibia Institute of Pathology for the time period of July 2012-April 2013. Data from 13 regions were collected. RESULTS The total number of specimens collected from patients with symptoms of pulmonary TB was 1 842. Of these, 594 (32.20%) were found to be positive for MTB by Xpert® MTB/RIF assay, out of which 443 (24.05%) were also found to be positive by microscopy. The remainder was negative. The male patients were more resistant to rifampicin when compared to the female patients. CONCLUSIONS Tuberculosis is widely distributed throughout Namibia, with slightly more males infected than females. Most TB patients are also co-infected with HIV. Both microscopy and Xpert® MTB/RIF assay are crucial for the diagnosis of TB in the country. Screening diagnostic efforts should focus on the sexually active HIV positive male population who could be the source of more RIF-resistant TB than females to prevent its spread.
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Affiliation(s)
- Rooyen T Mavenyengwa
- Department of Health Sciences, School of Health and Applied Sciences, Namibia University of Science and Technology, Private Bag 13388, Windhoek, Namibia. .,Department of Medical Microbiology, University of Zimbabwe College of Health Sciences, P. O. Box A178, Harare, Zimbabwe.
| | - Emma Shaduka
- Department of Health Sciences, School of Health and Applied Sciences, Namibia University of Science and Technology, Private Bag 13388, Windhoek, Namibia
| | - Innocent Maposa
- Department of Mathematics and Statistics, Namibia University of Science and Technology, Private Bag 13388, Windhoek, Namibia
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Brum CB, Ramos DF, Abilleira FDS, Silva ABS, von Groll A, Silva PEAD. The BACTEC MGIT(tm) 320 system as a laboratory tool to diagnose tuberculosis in a Brazilian hospital with a high prevalence of HIV infection. Rev Soc Bras Med Trop 2017; 49:112-4. [PMID: 27163574 DOI: 10.1590/0037-8682-0125-2015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 06/01/2015] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The World Health Organization endorses the BACTEC Mycobacterial Growth Indicator Tube (MGIT)(tm) system as a rapid, sensitive, and specific method to diagnostic of tuberculosis. Here, we compared the performance of this system against Ogawa-Kudoh cultures and microscopy. METHODS A total of 927 samples were obtained between December 2011 and December 2013 from 652 cases of suspected tuberculosis at the School Hospital of the Federal University of Rio Grande in Brazil. RESULTS The MGIT system confirmed tuberculosis in more cases in less time. CONCLUSIONS The MGIT system is an effective tool for early diagnosis of tuberculosis, especially in patients with HIV/AIDS.
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Affiliation(s)
- Clarice Brinck Brum
- Faculdade de Medicina, Núcleo de Pesquisa em Microbiologia Médica, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Daniela Fernandes Ramos
- Faculdade de Medicina, Núcleo de Pesquisa em Microbiologia Médica, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Fernanda de Souza Abilleira
- Faculdade de Medicina, Núcleo de Pesquisa em Microbiologia Médica, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Ana Bárbara Scholante Silva
- Faculdade de Medicina, Núcleo de Pesquisa em Microbiologia Médica, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Andrea von Groll
- Faculdade de Medicina, Núcleo de Pesquisa em Microbiologia Médica, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
| | - Pedro Eduardo Almeida da Silva
- Faculdade de Medicina, Núcleo de Pesquisa em Microbiologia Médica, Universidade Federal do Rio Grande, Rio Grande, Rio Grande do Sul, Brazil
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Hundie GB, Woldemeskel D, Gessesse A. Evaluation of Direct Colorimetric MTT Assay for Rapid Detection of Rifampicin and Isoniazid Resistance in Mycobacterium tuberculosis. PLoS One 2016; 11:e0169188. [PMID: 28030634 PMCID: PMC5193450 DOI: 10.1371/journal.pone.0169188] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 12/13/2016] [Indexed: 11/18/2022] Open
Abstract
With the spread of multidrug-resistant tuberculosis (MDR-TB) strains there is an increasing need for new accurate and cost-effective methods for a rapid diagnostic and drug susceptibility testing (DST), particularly in low-income countries where tuberculosis is hyperendemic. A colorimetric assay using 3-(4, 5-dimethylthiazol-2-yl)-2, 5- diphenyltetrazolium bromide (MTT) has been suggested as a promising method for DST, especially to rifampicin. In this study, we standardized and evaluated the MTT assay for a rapid direct detection of rifampicin and isoniazid resistant Mycobacterium tuberculosis strains from sputum specimens using Lowenstein-Jensen (LJ) culture medium as a gold standard. The MTT assay sensitivity, specificity, positive and negative predictive values for rifampicin were 100%, 86%, 100%, 99%, respectively. For isoniazid, the MTT assay had a 100% sensitivity, specificity, positive and negative predictive values. Interestingly, the MTT assay gave interpretable results within two weeks for 94% of the samples compared to 7–14 weeks for LJ media. Overall, an excellent agreement was observed between MTT assay and LJ proportion method (Kappa, 0.91 for rifampicin and 1.00 for isoniazid). In conclusion, the direct colorimetric MTT assay simultaneously detects susceptible and resistant strains of M. tuberculosis within three weeks. It significantly shortens the time required to obtain a DST result and could be a reliable alternative method for rapid detection of drug-resistant TB strains in high-TB-burden resource-limited settings.
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Affiliation(s)
- Gadissa Bedada Hundie
- Department of Microbial, Cellular and Molecular Biology, College of Natural Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | - Dawit Woldemeskel
- Biotechnology Institute, College of Natural Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Amare Gessesse
- Biotechnology Institute, College of Natural Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Coban AY, Akbal AU, Bicmen C, Albay A, Sig AK, Uzun M, Selale DS, Ozkutuk N, Surucuoglu S, Albayrak N, Ucarman N, Ozkutuk A, Esen N, Ceyhan I, Ozyurt M, Bektore B, Aslan G, Delialioğlu N, Alp A. Multicenter evaluation of crystal violet decolorization assay (CVDA) for rapid detection of isoniazid and rifampicin resistance in Mycobacterium tuberculosis. Sci Rep 2016; 6:39050. [PMID: 27982061 PMCID: PMC5159858 DOI: 10.1038/srep39050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 11/10/2016] [Indexed: 11/25/2022] Open
Abstract
The aim of this multicenter study was to evaluate the performance of the crystal violet decolorization assay (CVDA) for detection of multidrug resistant tuberculosis (MDR-TB). This study was performed in 11 centers in two phases. A total of 156 isolates were tested for INH and RIF resistance. In the phase I, 106 clinical isolates were tested in the Center 1–7. In the phase 2, 156 clinical isolates were tested in the center 1–6, center 8–11. Eighty six of 156 tested isolates were the same in phase I. Agreements were 96.2–96.8% for INH and 98.1–98.7% for RIF in the phase I-II, respectively. Mean time to obtain the results in the phase I was 14.3 ± 5.4 days. In the phase II, mean time to obtain the results was 11.6 ± 3.5 days. Test results were obtained within 14days for 62.3% (66/106) of isolates in the phase I and 81.4% (127/156) of isolates in the phase II. In conclusion, CVDA is rapid, reliable, inexpensive, and easy to perform for rapid detection of MDR-TB isolates. In addition, it could be adapted for drug susceptibility testing with all drugs both in developed and developing countries.
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Affiliation(s)
- Ahmet Yilmaz Coban
- Ondokuz Mayis University Medical School Department of Medical Microbiology, Samsun, Turkey
| | - Ahmet Ugur Akbal
- Ondokuz Mayis University Medical School Department of Medical Microbiology, Samsun, Turkey
| | - Can Bicmen
- Dr. Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, Medical Microbiology Laboratory, Izmir, Turkey
| | - Ali Albay
- Gulhane Military Medical Academy, Department of Medical Microbiology, Ankara, Turkey
| | - Ali Korhan Sig
- Gulhane Military Medical Academy, Department of Medical Microbiology, Ankara, Turkey
| | - Meltem Uzun
- Istanbul University Istanbul Medical School Department of Medical Microbiology, Istanbul, Turkey
| | - Deniz Sertel Selale
- Istanbul University Istanbul Medical School Department of Medical Microbiology, Istanbul, Turkey
| | - Nuri Ozkutuk
- Celal Bayar University Medical School Department of Medical Microbiology, Manisa, Turkey
| | - Suheyla Surucuoglu
- Celal Bayar University Medical School Department of Medical Microbiology, Manisa, Turkey
| | - Nurhan Albayrak
- Public Health Agency of Turkey Tuberculosis Reference Laboratory, Ankara, Turkey
| | - Nilay Ucarman
- Public Health Agency of Turkey Tuberculosis Reference Laboratory, Ankara, Turkey
| | - Aydan Ozkutuk
- Dokuz Eylul University Medical School Department of Medical Microbiology, Izmir, Turkey
| | - Nuran Esen
- Dokuz Eylul University Medical School Department of Medical Microbiology, Izmir, Turkey
| | - Ismail Ceyhan
- Atatürk Chest Diseases and Chest Surgery Training and Research Hospital Medical Microbiology Laboratory, Ankara, Turkey
| | - Mustafa Ozyurt
- Haydarpasa Military Medical Academy, Department of Medical Microbiology, Istanbul, Turkey
| | - Bayhan Bektore
- Haydarpasa Military Medical Academy, Department of Medical Microbiology, Istanbul, Turkey
| | - Gonul Aslan
- Mersin University Medical School Department of Medical Microbiology, Mersin, Turkey
| | - Nuran Delialioğlu
- Mersin University Medical School Department of Medical Microbiology, Mersin, Turkey
| | - Alpaslan Alp
- Hacettepe University Medical School Department of Medical Microbiology, Ankara, Turkey
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Rocha VCF, Figueiredo SCD, Rosales CAR, Porto CD, Sequeira JL, Neto JSF, Paes AC, Salgado VR. Infection by Mycobacterium bovis in a dog from Brazil. Braz J Microbiol 2016; 48:109-112. [PMID: 27914739 PMCID: PMC5220626 DOI: 10.1016/j.bjm.2016.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 04/25/2016] [Indexed: 11/01/2022] Open
Abstract
Tuberculosis (TB) is a chronic disease caused by bacteria belonging to the Mycobacterium tuberculosis complex (MtbC). This disease rarely affects dogs. Canine infections are usually caused by M. tuberculosis. Mycobacterium bovis infections are rare in dogs and associated with consumption of raw milk or contaminated products. Here, we report a Boxer dog who had a M. bovis infection and was admitted to a Brazilian veterinary hospital with a presumptive diagnosis of chronic ehrlichiosis. Despite receiving treatment for chronic ehrlichiosis, it progressed to death. TB was diagnosed during post-mortem examinations using histopathological analysis. Ziehl-Neelsen staining revealed acid-fast bacilli in the kidneys, liver, mesentery, and a mass adhered to the liver. Further, PCR-restriction analysis was performed to identify mycobacteria in the samples. A restriction profile compatible with MtbC was found in the lungs. In addition, PCR-based MtbC typing deletions at different loci of chromosome 9 enabled the identification of M. bovis in the lungs. Therefore, it is very essential to perform differential diagnosis of TB in dogs with non-specific clinical signs and who do not respond to treatment, particularly those who had been in contact with TB-infected cattle or owners. Further, we highlight the use of molecular methods for the identification of bacilli, improving the diagnosis and aiding epidemiological studies.
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Affiliation(s)
| | - Salomão Cambuí de Figueiredo
- Instituto Federal de Educação, Ciência e Tecnologia da Paraíba (IFPB), Faculdade de Medicina Veterinária, Sousa, PB, Brazil
| | | | | | - Julio Lopes Sequeira
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina Veterinária e Zootecnia (FMVZ), Botucatu, SP, Brazil
| | - José Soares Ferreira Neto
- Universidade de São Paulo (USP), Faculdade de Medicina Veterinária e Zootecnia (FMVZ), São Paulo, SP, Brazil
| | - Antônio Carlos Paes
- Universidade Estadual Paulista (UNESP), Faculdade de Medicina Veterinária e Zootecnia (FMVZ), Botucatu, SP, Brazil
| | - Vanessa Riesz Salgado
- Universidade de São Paulo (USP), Faculdade de Medicina Veterinária e Zootecnia (FMVZ), São Paulo, SP, Brazil.
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Abstract
Tuberculosis (TB), caused byMycobacterium tuberculosis(M.tb.), is one of the most prevalent and serious infectious diseases worldwide with an estimated annual global mortality of 1.4 million in 2010.
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Affiliation(s)
- Saurabh K. Srivastava
- Plant Research International
- Wageningen UR
- 6708 PB Wageningen
- The Netherlands
- Laboratory of Organic Chemistry
| | - Cees J. M. van Rijn
- Laboratory of Organic Chemistry
- Wageningen UR
- 6703 HB Wageningen
- The Netherlands
| | - Maarten A. Jongsma
- Plant Research International
- Wageningen UR
- 6708 PB Wageningen
- The Netherlands
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Comparison of cyp141 and IS6110 for detection of Mycobacterium tuberculosis from clinical specimens by PCR. J Infect Public Health 2014; 8:32-6. [PMID: 25304426 DOI: 10.1016/j.jiph.2014.08.005] [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: 01/05/2014] [Revised: 04/23/2014] [Accepted: 08/24/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Tuberculosis is a major public health problem throughout the world. TB's worldwide patterns of prevalence coupled with the increase in incidence of HIV infection threaten the health and lives of humans worldwide. Rapid detection of TB and the rapidly initiation of the administration of medication are important strategies for stopping the transmission of this disease transmission and its resistance to anti-TB drugs. Molecular methods are advantageous relative to conventional techniques due to their greater speed and sensitivity in the detection of TB. METHODS In this study, we targeted the cyp141 gene for the detection of Mycobacterium tuberculosis from clinical specimens (n=123) by PCR and compared the sensitivity and specificity of this new target with those of IS6110 gene. RESULTS Targeting of the cyp141 gene is more sensitive (97.1% for cultured isolates and 85.7% for direct specimens) than the targeting of the commonly used IS6110 gene (95.1% for cultured isolates and 42.9% for direct specimens), and the specificities of these two target genes were equal (100%). CONCLUSIONS The cyp141 gene can be used as a new target for the direct detection of Mycobacterium tuberculosis that seems to be superior to IS6110.
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Hernández Sarmiento JM, Martínez Negrete MA, Castrillón Velilla DM, Mejía Espinosa SA, Mejía Mesa GI, Zapata Fernández EM, Rojas Jiménez S, Marín Castro AE, Robledo Restrepo JA. Agar de capa delgada: Una opción costoefectiva para el diagnóstico rápido de tuberculosis multirresistente. Rev Salud Publica (Bogota) 2014. [DOI: 10.15446/rsap.v16n1.31316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Al-Anazi KA, Al-Jasser AM, Alsaleh K. Infections Caused by Mycobacterium tuberculosis in Recipients of Hematopoietic Stem Cell Transplantation. Front Oncol 2014; 4:231. [PMID: 25207262 PMCID: PMC4144006 DOI: 10.3389/fonc.2014.00231] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 08/11/2014] [Indexed: 12/11/2022] Open
Abstract
Mycobacterium tuberculosis (M. tuberculosis) infections are uncommon in recipients of hematopoietic stem cell transplantation. These infections are 10-40 times commoner in recipients of stem cell transplantation than in the general population but they are 10 times less in stem cell transplantation recipients compared to solid organ transplant recipients. The incidence of M. tuberculosis infections in recipients of allogeneic stem cell transplantation ranges between <1 and 16% and varies considerably according to the type of transplant and the geographical location. Approximately 80% of M. tuberculosis infections in stem cell transplant recipients have been reported in patients receiving allografts. Several risk factors predispose to M. tuberculosis infections in recipients of hematopoietic stem cell transplantation and these are related to the underlying medical condition and its treatment, the pre-transplant conditioning therapies in addition to the transplant procedure and its own complications. These infections can develop as early as day 11 and as late as day 3337 post-transplant. The course may become rapidly progressive and the patient may develop life-threatening complications. The diagnosis of M. tuberculosis infections in stem cell transplant recipients is usually made on clinical grounds, cultures obtained from clinical specimens, tissues biopsies in addition to serology and molecular tests. Unfortunately, a definitive diagnosis of M. tuberculosis infections in these patients may occasionally be difficult to be established. However, M. tuberculosis infections in transplant recipients usually respond well to treatment with anti-tuberculosis agents provided the diagnosis is made early. A high index of suspicion should be maintained in recipients of stem cell transplantation living in endemic areas and presenting with compatible clinical and radiological manifestations. High mortality rates are associated with infections caused by multidrug-resistant strains, miliary or disseminated infections, and delayed initiation of therapy. In recipients of hematopoietic stem cell transplantation, isoniazid prophylaxis has specific indications and bacillus Calmette-Guerin vaccination is contraindicated as it may lead to disseminated infection. The finding that M. tuberculosis may maintain long-term intracellular viability in human bone marrow-derived mesenchymal stem cells complicates the development of effective vaccines and strategies to eliminate tuberculosis. However, the introduction of linezolid, cellular immunotherapy, and immunomodulation in addition to autologous mesenchymal stem cell transplantation will ultimately have a positive impact on the overall management of infections caused by M. tuberculosis.
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Affiliation(s)
- Khalid Ahmed Al-Anazi
- Section of Adult Hematology and Oncology, Department of Medicine, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
| | | | - Khalid Alsaleh
- Section of Adult Hematology and Oncology, Department of Medicine, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
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Phunpae P, Chanwong S, Tayapiwatana C, Apiratmateekul N, Makeudom A, Kasinrerk W. Rapid diagnosis of tuberculosis by identification of Antigen 85 in mycobacterial culture system. Diagn Microbiol Infect Dis 2014; 78:242-8. [DOI: 10.1016/j.diagmicrobio.2013.11.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 11/22/2013] [Accepted: 11/24/2013] [Indexed: 11/17/2022]
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Lima AS, Duarte RS, Montenegro LML, Schindler HC. Rapid detection and differentiation of mycobacterial species using a multiplex PCR system. Rev Soc Bras Med Trop 2014; 46:447-52. [PMID: 23982098 DOI: 10.1590/0037-8682-0097-2013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 07/22/2013] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The early diagnosis of mycobacterial infections is a critical step for initiating treatment and curing the patient. Molecular analytical methods have led to considerable improvements in the speed and accuracy of mycobacteria detection. METHODS The purpose of this study was to evaluate a multiplex polymerase chain reaction system using mycobacterial strains as an auxiliary tool in the differential diagnosis of tuberculosis and diseases caused by nontuberculous mycobacteria (NTM) RESULTS: Forty mycobacterial strains isolated from pulmonary and extrapulmonary origin specimens from 37 patients diagnosed with tuberculosis were processed. Using phenotypic and biochemical characteristics of the 40 mycobacteria isolated in LJ medium, 57.5% (n=23) were characterized as the Mycobacterium tuberculosis complex (MTBC) and 20% (n=8) as nontuberculous mycobacteria (NTM), with 22.5% (n=9) of the results being inconclusive. When the results of the phenotypic and biochemical tests in 30 strains of mycobacteria were compared with the results of the multiplex PCR, there was 100% concordance in the identification of the MTBC and NTM species, respectively. A total of 32.5% (n=13) of the samples in multiplex PCR exhibited a molecular pattern consistent with NTM, thus disagreeing with the final diagnosis from the attending physician. CONCLUSIONS Multiplex PCR can be used as a differential method for determining TB infections caused by NTM a valuable tool in reducing the time necessary to make clinical diagnoses and begin treatment. It is also useful for identifying species that were previously not identifiable using conventional biochemical and phenotypic techniques.
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Affiliation(s)
- Andrea Santos Lima
- Departamento de Imunologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife,
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da Silva CT, Behrsin RF, Cardoso GP, de Araújo EG. Evaluation of adenosine deaminase activity for the diagnosis of pleural TB in lymphocytic pleural effusions. Biomark Med 2013; 7:113-8. [PMID: 23387492 DOI: 10.2217/bmm.12.89] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM To evaluate the diagnostic value of pleural adenosine deaminase (P-ADA) as a pleural TB-specific biomarker in lymphocytic pleural effusions. MATERIALS & METHODS Pleural effusions were classified on the basis of definitive diagnosis. RESULTS A total of 218 patients (122 tuberculous and 96 nontuberculous) were included in the study. The optimal cut-off value of P-ADA (receiver operating characteristic curve) for the diagnosis of pleural TB was 40.0 U/l (Giusti method). In lymphocytic pleural effusions P-ADA had a sensitivity of 80.3%, a specificity of 96.0% and an accuracy of 86.2%. The positive predictive value was 97.0% and the negative predictive value was 75.0%. The positive likelihood ratio and negative likelihood ratio were 19.8 and 0.2, respectively (p < 0.0001). CONCLUSION P-ADA activity is recommended for the diagnosis of TB in lymphocytic pleural effusions.
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Affiliation(s)
- Cyro Teixeira da Silva
- Departamento de Medicina Clínica da Faculdade de Medicina da Universidade Federal Fluminense, Rio de Janeiro, Brazil.
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Nafae RM, Mohammad MA, El-Gammal MS, Abdullah MA. Use of enzyme linked immunospot assay (ELISpot) for monitoring treatment response of pulmonary tuberculosis patients. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2013. [DOI: 10.1016/j.ejcdt.2013.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Rapid confirmation of drug susceptibility in Mycobacterium tuberculosis using MPT 64 Ag based test. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2013. [DOI: 10.1016/s2222-1808(13)60042-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Hiatt LA, Cliffel DE. Real-time Recognition of Mycobacterium tuberculosis and Lipoarabinomannan using the Quartz Crystal Microbalance. SENSORS AND ACTUATORS. B, CHEMICAL 2012; 174:245-252. [PMID: 23175600 PMCID: PMC3500912 DOI: 10.1016/j.snb.2012.06.095] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A quartz crystal microbalance (QCM) immunosensor has been successfully employed to screen for both whole Mycobacteria tuberculosis (Mtb) bacilli and a Mtb surface antigen, lipoarabinomannan (LAM). One of the most abundant components of the Mtb cell surface, LAM, may be detected without the presence of the entire bacterium. Using available antibodies with proven utility in enzyme-linked immunoassays (ELISAs), a sensor was designed to measure Mtb bacilli and LAM. Equilibrium association constants (K(a)) were determined for the interaction of Mtb with immobilized α-LAM and anti-H37Rv antibodies, where avidity was seen to strengthen this interaction and provide for greater binding than might have otherwise been achieved. The binding of LAM to immobilized α-LAM had a high associate rate constant (k(a)) allowing for rapid detection. Evaluating these binding constants helped the compare the sensitivity of these immunosensors to conventional ELISAs. The use of these assays with the better antibodies may allow for immunosensor use in determining LAM as a point-of-care (POC) diagnostic for Mtb.
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Affiliation(s)
- Leslie A. Hiatt
- Department of Chemistry, Vanderbilt University, 7330 Stevenson Center, VU Station B 351822, Nashville, TN 37235-1822 USA
| | - David E. Cliffel
- Department of Chemistry, Vanderbilt University, 7330 Stevenson Center, VU Station B 351822, Nashville, TN 37235-1822 USA
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Darban-Sarokhalil D, Imani Fooladi AA, Maleknejad P, Bameri Z, Aflaki M, Nomanpour B, Yaslianifard S, Modarresi MH, Feizabadi MM. Comparison of smear microscopy, culture, and real-time PCR for quantitative detection of Mycobacterium tuberculosis in clinical respiratory specimens. ACTA ACUST UNITED AC 2012; 45:250-5. [PMID: 23113553 DOI: 10.3109/00365548.2012.727465] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND As a rapid diagnostic technique, the real-time polymerase chain reaction (PCR) can detect Mycobacterium tuberculosis with a high sensitivity and specificity. However, further studies are needed to confirm it as a standard method. In this study, we evaluated the cyp141 gene for the detection and quantification of M. tuberculosis in respiratory specimens and compared the results with direct microscopy and culture. METHODS Sputum samples (n = 247) were collected from patients of the different provinces of Iran. DNA was extracted from clinical specimens and H37Rv strain. After measuring the standard strain DNA concentration by NanoDrop and using the Avogadro number, the DNA was diluted 6 times in order to obtain 1 × 10(6) to 10 template copies. A Taqman probe was designed for detection of the target in a real-time PCR using the specific primers. RESULTS Of 247 samples, 135 (55%) were culture-negative. Of 112 (45%) culture-positive samples, 88 were positive by both smear and culture and 24 were smear-negative but culture-positive. The real-time PCR enumerated 1.5E + 02 to 4.3E+ 03, 8.5E + 03 to 5.5E + 04, 7.2E + 04 to 1.1E + 06, and 1.2E + 06 to 8.1E + 07 M. tuberculosis cells in the specimens with smear-negative, 1-plus, 2-plus, and 3-plus codes, respectively. The overall sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the real-time PCR were 90.2% (101/112), 97.8% (132/135), 97.1%, and 92.3%, respectively. CONCLUSIONS The overall sensitivity and specificity, the results in comparison with those of the Xpert MTB/RIF kit, and the good correlation with molecular and phenotypic methods, show that cyp141 could be a good target for the quantification of M. tuberculosis in sputum and possibly other clinical specimens.
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Affiliation(s)
- Davood Darban-Sarokhalil
- Department of Pathobiology, School of Medicine, Alborz university of Medical Sciences, Karaj, Iran
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Bonnet M. Les nouveaux tests diagnostiques de la tuberculose maladie : de la théorie à la pratique dans les pays du Sud. Rev Mal Respir 2011; 28:1310-21. [DOI: 10.1016/j.rmr.2011.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Accepted: 04/02/2011] [Indexed: 11/16/2022]
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Evaluation of nitrate reduction assay, resazurin microtiter assay and microscopic observation drug susceptibility assay for first line antitubercular drug susceptibility testing of clinical isolates of M. tuberculosis. J Microbiol Methods 2011; 88:122-6. [PMID: 22133919 DOI: 10.1016/j.mimet.2011.11.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 10/22/2011] [Accepted: 11/01/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND Drug resistant tuberculosis (TB) is a growing concern worldwide. Early detection of multidrug-resistant Mycobacterium tuberculosis is of primary importance for both patient management and infection control. Optimal method for identifying drug-resistant M. tuberculosis in a timely and affordable way in resource-limited settings is not yet available. AIM This study evaluated; nitrate reductase assay (NRA), resazurin microtiter assay (REMA) and microscopic observation drug susceptibility assay (MODS) against the conventional 1% proportion method (PM) for the detection of resistance to first line antitubercular drugs, in M. tuberculosis clinical isolates. METHODS A total of one hundred and five clinical isolates of M. tuberculosis; 50 pan sensitive and 55 pan resistant were tested with NRA, REMA and MODS. The 1% proportion method on Lowenstein-Jensen medium was used as reference test. RESULTS Of all three methods which were tested NRA was found to be most sensitive and specific. Sensitivity for rifampicin resistance detection was 100%, 94.55% and 92.73% by NRA, REMA and MODS respectively. NRA and REMA were found to be 100% specific, while the MODS was 98% specific for detection of rifampicin resistance. Test results with all these methods were obtained within 8-14 days. CONCLUSION Rapid non-conventional and inexpensive methods may serve as a replacement for 1% proportion method in resource limited settings.
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Gomez DI, Mullin CS, Mora-Guzmán F, Crespo-Solis JG, Fisher-Hoch SP, McCormick JB, Restrepo BI. Rapid DNA extraction for specific detection and quantitation of Mycobacterium tuberculosis DNA in sputum specimens using Taqman assays. Tuberculosis (Edinb) 2011; 91 Suppl 1:S43-8. [PMID: 22088321 DOI: 10.1016/j.tube.2011.10.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Rapid tuberculosis (TB) detection is critical for disease control, and further quantitation of Mycobacterium tuberculosis (Mtb) in sputum is valuable for epidemiological and clinical studies. We evaluated a simple, robust and cost-efficient in-house DNA extraction and downstream Taqman approach for detection and quantitation of Mtb genomes from sputum of newly-diagnosed TB patients and non-TB controls. DNA was extracted using guanidine isothiocyanate and silica-based spin columns in less than 2 h, stored frozen, and Taqman assays were used to detect Mtb with IS6110 and quantify it targeting RD1 and IS1081. The Taqmans had a sensitivity >95% in 108 culture-confirmed TB patients and specificity of 100% in 43 non-TB controls. Genome counts were correlated with the Mycobacterial Growth Indicator Tubes' (MGIT) time-to-detection values (1/TTD × 1000; rho = 0.66; p < 0.001) in 91 TB patients (33 excluded with MGIT contamination). This linear relationship was nearly identical between mycobacteria isolated from sputum and H37Rv Mtb grown in-vitro to its log phase. TB treatment between 3 and 7 days was associated with lower 1/TTD × 1000 values but not with genome counts. Together, our protocol provides rapid, specific, inexpensive and quantitative detection of Mtb DNA in fresh or stored sputa making it a robust tool for prompt TB diagnosis, and with potential use for clinical and epidemiologic studies.
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Affiliation(s)
- Diana I Gomez
- Division of Epidemiology, School of Public Health in Brownsville, University of Texas Health Science Center at Houston, 80 Fort Brown, SPH Bldg, Brownsville, Texas 78520, USA
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Ekrami A, Samarbaf-Zadeh AR, Khosravi A, Zargar B, Alavi M, Amin M, Kiasat A. Validity of bioconjugated silica nanoparticles in comparison with direct smear, culture, and polymerase chain reaction for detection of Mycobacterium tuberculosis in sputum specimens. Int J Nanomedicine 2011; 6:2729-35. [PMID: 22114503 PMCID: PMC3218586 DOI: 10.2147/ijn.s23239] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Tuberculosis is a public health problem worldwide, and new easy to perform diagnostic methods with high accuracy are necessary for optimal control of the disease. Recently, fluorescent silica nanoparticles (FSNP) has attracted immense interest for the detection of pathogenic microorganisms. The aim of this study was to detect Mycobacterium tuberculosis in clinical samples using bioconjugated FSNP compared with microscopic examination, polymerase chain reaction (PCR), nested PCR, and culture as the gold standard. METHODS In total, 152 sputum specimens were obtained from patients who were suspected to have pulmonary tuberculosis. All samples were examined by the four techniques described. RESULTS The assay showed 97.1% sensitivity (95% confidence interval [CI] 91-99.2) and 91.35% specificity (CI 78.3-97.1). Furthermore, assays using variable bacterial concentrations indicated that 100 colony forming units/mL of M. tuberculosis could be detected. There were no differences between the results obtained from two types of mouse monoclonal antibody against Hsp-65 and 16 KDa antigens. CONCLUSION We performed this assay in a large number of clinical samples to confirm the diagnostic specificity and sensitivity of the test and can recommend its application for diagnosis of M. tuberculosis. We believe that this method is more convenient for routine diagnosis of M. tuberculosis in sputum and will be more easily applicable in the field, and with sufficient sensitivity.
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Affiliation(s)
- Alireza Ekrami
- Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Mironova S, Pimkina E, Kontsevaya I, Nikolayevskyy V, Balabanova Y, Skenders G, Kummik T, Drobniewski F. Performance of the GenoType® MTBDRPlus assay in routine settings: a multicenter study. Eur J Clin Microbiol Infect Dis 2011; 31:1381-7. [DOI: 10.1007/s10096-011-1453-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 10/07/2011] [Indexed: 10/16/2022]
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Darban-Sarokhalil D, Fooladi A, Bameri Z, Nasiri M, Feizabadi M. Cytochrome CYP141: a new target for direct detection of Mycobacterium tuberculosis from clinical specimens. Acta Microbiol Immunol Hung 2011; 58:211-7. [PMID: 21983322 DOI: 10.1556/amicr.58.2011.3.4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Cytochrome P450 CYP141 is an intermediary metabolic and respiratory protein that interferes with oxidation reduction in Mycobacterium tuberculosis. This conserved protein has also been debated as a hypothetical target for therapeutics. We used the sequences of CYP141 gene to develop a PCR for rapid detection of Mycobacterium tuberculosis from respiratory specimens. The sensitivity of this PCR for culture positive-smear positive and culture positive-smear negative samples were 92% and 62.5%, respectively. The overall sensitivity and specificity of this PCR was 85.7% and 97.8%. As compared with other studies, it appears that the CYP141 gene is a good target for direct detection of M. tuberculosis from respiratory specimens.
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Affiliation(s)
- Davood Darban-Sarokhalil
- 1 Tehran University of Medical Sciences Department of Microbiology, School of Medicine Tehran Iran
| | - Abbas Fooladi
- 2 Baqiyatallah University of Medical Sciences Applied Microbiology Research Center Tehran Iran
| | - Zakaria Bameri
- 3 Zahedan University of Medical Sciences Research Center for Infectious Diseases and Tropical Medicine, Boo-Ali Hospital Zahedan Iran
| | - Mohammad Nasiri
- 1 Tehran University of Medical Sciences Department of Microbiology, School of Medicine Tehran Iran
| | - Mohammad Feizabadi
- 1 Tehran University of Medical Sciences Department of Microbiology, School of Medicine Tehran Iran
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Velásquez GE, Yagui M, Cegielski JP, Asencios L, Bayona J, Bonilla C, Jave HO, Yale G, Suárez C, Atwood S, Contreras CC, Shin SS. Targeted drug-resistance testing strategy for multidrug-resistant tuberculosis detection, Lima, Peru, 2005-2008. Emerg Infect Dis 2011; 17:432-40. [PMID: 21392434 PMCID: PMC3166030 DOI: 10.3201/eid1703.101553] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Running head: Targeted Drug-Resistance Testing Strategy for MDR TB The Peruvian National Tuberculosis Control Program issued guidelines in 2006 specifying criteria for culture and drug-susceptibility testing (DST), including district-level rapid DST. All patients referred for culture and DST in 2 districts of Lima, Peru, during January 2005–November 2008 were monitored prospectively. Of 1,846 patients, 1,241 (67.2%) had complete DST results for isoniazid and rifampin; 419 (33.8%) patients had multidrug-resistant (MDR) TB at the time of referral. Among patients with new smear-positive TB, household contact and suspected category I failure were associated with MDR TB, compared with concurrent regional surveillance data. Among previously treated patients with smear-positive TB, adult household contact, suspected category II failure, early relapse after category I, and multiple previous TB treatments were associated with MDR TB, compared with concurrent regional surveillance data. The proportion of MDR TB detected by using guidelines was higher than that detected by a concurrent national drug-resistance survey, indicating that the strategy effectively identified patients for DST.
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Alcaide F, Coll P. Advances in rapid diagnosis of tuberculosis disease and anti-tuberculous drug resistance. Enferm Infecc Microbiol Clin 2011; 29 Suppl 1:34-40. [PMID: 21420565 DOI: 10.1016/s0213-005x(11)70016-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Rapid diagnosis of tuberculosis (TB) and multidrug-resistant (resistance to at least rifampin and isoniazid) Mycobacterium tuberculosis (MDR-TB) is one of the cornerstones for global TB control as it allows early epidemiological and therapeutic interventions. The slow growth of the tubercle bacillus is the greatest obstacle to rapid diagnosis of the disease. However, considerable progress has recently been made in developing novel diagnostic tools, especially molecular methods (commercial and 'in-house'), for direct detection in clinical specimens. These methods, based on nucleic acid amplification (NAA) of different targets, aim to identify the M. tuberculosis complex and detect the specific chromosome mutations that are most frequently associated with phenotypic resistance to multiple drugs. In general, commercial methods are recommended since they have a better level of standardization, reproducibility and automation. Although some aspects such as cost-efficiency and the appropriate setting for the implementation of these techniques are not yet well established, organizations such as the WHO are strongly supporting the implementation and universal use of these new molecular methods. This chapter summarizes current knowledge and the available molecular methods for rapid diagnosis of TB and anti-tuberculous drug resistance in clinical microbiology laboratories.
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Affiliation(s)
- Fernando Alcaide
- Servicio de Microbiología, IDIBELL-Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
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Nanoparticle based DNA biosensor for tuberculosis detection using thermophilic helicase-dependent isothermal amplification. Biosens Bioelectron 2011; 26:4614-8. [PMID: 21616654 DOI: 10.1016/j.bios.2011.04.055] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 04/27/2011] [Accepted: 04/28/2011] [Indexed: 11/23/2022]
Abstract
The present study describes the development of a DNA based biosensor to detect Mycobacterium tuberculosis using thermophilic helicase-dependent isothermal amplification (tHDA) and dextrin coated gold nanoparticles (AuNPs) as electrochemical reporter. The biosensor is composed of gold nanoparticles (AuNPs) and amine-terminated magnetic particles (MPs) each functionalized with a different DNA probe that specifically hybridize with opposite ends of a fragment within the IS6110 gene, which is M. tuberculosis complex (MTC) specific. After hybridization, the formed complex (MP-target-AuNP) is magnetically separated from the solution and the AuNPs are electrochemically detected on a screen printed carbon electrode (SPCE) chip. The obtained detection limit is 0.01 ng/μl of isothermally amplified target (105 bp). This biosensor system can be potentially implemented in peripheral laboratories with the use of a portable, handheld potentiostat.
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Chaudhary M, Gupta S, Khare S, Lal S. Diagnosis of tuberculosis in an era of HIV pandemic: a review of current status and future prospects. Indian J Med Microbiol 2011; 28:281-9. [PMID: 20966555 DOI: 10.4103/0255-0857.71805] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
HIV and tuberculosis co-infection interact in fundamentally important ways. This interaction is evident patho-physiologically, clinically and epidemiologically. There are several differences between HIV-infected and HIV-uninfected patients with tuberculosis (TB) that have practical diagnostic implications. TB is more likely to be disseminated in nature and more difficult to diagnose by conventional diagnostic procedures as immunosuppression progresses. As TB rates continue to increase in HIV-endemic regions, improved diagnostic techniques merit consideration as TB-control strategies. There is a need to develop more user friendly techniques, which can be adapted for use in the high-burden and low-income countries. This review focuses on the diagnostic challenges in HIV-TB co-infection with an update on the current techniques and future prospects in an era of HIV pandemic.
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Affiliation(s)
- M Chaudhary
- Microbiology Division, National Institute of Communicable Diseases, Delhi, India.
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Jiang J, Chai Y, Cui H. The electrogenerated chemiluminescence detection of IS6110 of Mycobacterium tuberculosis based on a luminol functionalized gold nanoprobe. RSC Adv 2011. [DOI: 10.1039/c1ra00206f] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Ereqat S, Bar-Gal GK, Nasereddin A, Said S, Greenblatt CL, Azmi K, Qaddomi SE, Spigelman M, Ramlawi A, Abdeen Z. Pulmonary tuberculosis in the West Bank, Palestinian Authority: molecular diagnostic approach. Trop Med Int Health 2010; 16:360-7. [DOI: 10.1111/j.1365-3156.2010.02697.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kashyap RS, Ramteke SS, Gaherwar HM, Deshpande PS, Purohit HJ, Taori GM, Daginawala H. Evaluation of BioFM liquid medium for culture of cerebrospinal fluid in tuberculous meningitis to identify Mycobacterium tuberculosis. Indian J Med Microbiol 2010; 28:366-9. [PMID: 20966571 DOI: 10.4103/0255-0857.71820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The present study was designed to evaluate the sensitivity and specificity of liquid culture medium (BioFM broth) for the diagnosis of tuberculous meningitis (TBM) in cerebrospinal fluid (CSF). CSF samples from 200 patients (TBM group = 150 and non-TBM group = 50) were tested for culture of Mycobacterium tuberculosis in BioFM liquid culture medium. Out of 150 TBM cases, 120 were found to be culture positive, indicating a sensitivity of 80% in BioFM broth within 2-3 weeks of inoculation. Positive cultures were also observed for CSF from 32 (64%) out of 50 non-TBM patients in BioFM liquid culture medium within 4 days of sample inoculation. Therefore, according to our study, BioFM broth system yielded 80% sensitivity [95% confidence interval (CI): 67-93%] and 36% specificity (95% CI: 57-98%) for TBM diagnosis. Our results indicate that although BioFM broth allows the detection of positive cultures within a shorter time, it has a high potential for contamination or for the coexistence of M. tuberculosis and non-tuberculous meningitis (NTM). This coexistence may go undetected or potentially lead to erroneous reporting of results.
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Affiliation(s)
- R S Kashyap
- Biochemistry Research Laboratory, Central India Institute of Medical Sciences, Nagpur, India
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Shrivastav R, Punde RP, Pandey H, Samarth R, Maudar K. Evolutionary Development of Molecular Tools in the Diagnosis of Mycobacterium tuberculosis: A Review. JOURNAL OF MEDICAL SCIENCES 2010. [DOI: 10.3923/jms.2010.124.129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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PCR-single-strand conformational polymorphism method for rapid detection of rifampin-resistant Mycobacterium tuberculosis: systematic review and meta-analysis. J Clin Microbiol 2010; 48:3635-40. [PMID: 20668134 DOI: 10.1128/jcm.00960-10] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The reference standard methods for drug susceptibility testing of Mycobacterium tuberculosis, such as culture on Lowenstein-Jensen or Middlebrook 7H10/11 medium, are very slow to give results; and due to the emergence of multidrug-resistant M. tuberculosis and extensively drug-resistant M. tuberculosis, there is an urgent demand for new, rapid, and accurate drug susceptibility testing methods. PCR-single-strand conformational polymorphism (PCR-SSCP) analysis has been proposed as a rapid method for the detection of resistance to rifampin, but its accuracy has not been systematically evaluated. We performed a systematic review and meta-analysis to evaluate the accuracy of PCR-SSCP analysis for the detection of rifampin-resistant tuberculosis. We searched the Medline, Embase, Web of Science, BIOSIS, and LILACS databases and contacted authors if additional information was required. Ten studies met our inclusion criteria for rifampin resistance detection. We applied the summary receiver operating characteristic (SROC) curve to perform the meta-analysis and to summarize diagnostic accuracy. The sensitivity of PCR-SSCP analysis for the rapid detection of rifampin-resistant tuberculosis was 0.79 (95% confidence interval [CI], 0.75 to 0.82), the specificity was 0.96 (95% CI, 0.94 to 0.98), the positive likelihood ratio was 16.10 (95% CI, 5.87 to 44.13), the negative likelihood ratio was 0.20 (95% CI, 0.10 to 0.40), and the diagnostic odds ratio was 100.93 (95% CI, 31.95 to 318.83). PCR-SSCP analysis is a sensitive and specific test for the rapid detection of rifampin-resistant M. tuberculosis. Additional studies in countries with a high prevalence of multidrug-resistant M. tuberculosis and also cost-effectiveness analysis are required in order to obtain a complete picture on the utility of this method for rapid drug resistance detection in M. tuberculosis.
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Fluorescent nanoparticle-based indirect immunofluorescence microscopy for detection of Mycobacterium tuberculosis. J Biomed Biotechnol 2010; 2007:89364. [PMID: 18273415 PMCID: PMC2219406 DOI: 10.1155/2007/89364] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2007] [Revised: 07/10/2007] [Accepted: 10/10/2007] [Indexed: 12/04/2022] Open
Abstract
A method of fluorescent nanoparticle-based indirect immunofluorescence microscopy
(FNP-IIFM) was developed for the rapid detection of Mycobacterium tuberculosis.
An anti-Mycobacterium tuberculosis antibody was used as primary antibody to recognize
Mycobacterium tuberculosis, and then an antibody binding protein (Protein A) labeled with
Tris(2,2-bipyridyl)dichlororuthenium(II) hexahydrate (RuBpy)-doped silica nanoparticles was
used to generate fluorescent signal for microscopic examination. Prior to the detection, Protein A was immobilized on RuBpy-doped silica nanoparticles with a coverage of ∼5.1×102 molecules/nanoparticle. With this method, Mycobacterium tuberculosis in bacterial mixture as
well as in spiked sputum was detected. The use of the fluorescent nanoparticles reveals amplified
signal intensity and higher photostability than the direct use of conventional fluorescent dye as
label. Our preliminary studies have demonstrated the potential application of the FNP-IIFM
method for rapid detection of Mycobacterium tuberculosis in clinical samples.
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Conde MB, Melo FAFD, Marques AMC, Cardoso NC, Pinheiro VGF, Dalcin PDTR, Machado Junior A, Lemos ACM, Netto AR, Durovni B, Sant'Anna CC, Lima D, Capone D, Barreira D, Matos ED, Mello FCDQ, David FC, Marsico G, Afiune JB, Silva JRLE, Jamal LF, Telles MADS, Hirata MH, Dalcolmo MP, Rabahi MF, Cailleaux-Cesar M, Palaci M, Morrone N, Guerra RL, Dietze R, Miranda SSD, Cavalcante SC, Nogueira SA, Nonato TSG, Martire T, Galesi VMN, Dettoni VDV. III Brazilian Thoracic Association Guidelines on tuberculosis. J Bras Pneumol 2010; 35:1018-48. [PMID: 19918635 DOI: 10.1590/s1806-37132009001000011] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Accepted: 08/25/2009] [Indexed: 11/21/2022] Open
Abstract
New scientific articles about tuberculosis (TB) are published daily worldwide. However, it is difficult for health care workers, overloaded with work, to stay abreast of the latest research findings and to discern which information can and should be used in their daily practice on assisting TB patients. The purpose of the III Brazilian Thoracic Association (BTA) Guidelines on TB is to critically review the most recent national and international scientific information on TB, presenting an updated text with the most current and useful tools against TB to health care workers in our country. The III BTA Guidelines on TB have been developed by the BTA Committee on TB and the TB Work Group, based on the text of the II BTA Guidelines on TB (2004). We reviewed the following databases: LILACS (SciELO) and PubMed (Medline). The level of evidence of the cited articles was determined, and 24 recommendations on TB have been evaluated, discussed by all of the members of the BTA Committee on TB and of the TB Work Group, and highlighted. The first version of the present Guidelines was posted on the BTA website and was available for public consultation for three weeks. Comments and critiques were evaluated. The level of scientific evidence of each reference was evaluated before its acceptance for use in the final text.
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