Laboratory Diagnosis of Tuberculosis: Advances in Technology and Drug Susceptibility Testing

被引:26
作者
Oommen, Seema [1 ]
Banaji, Nandita [2 ]
机构
[1] Pushpagiri Inst Med Sci & Res Ctr, Dept Microbiol, Tiruvalla 689101, Kerala, India
[2] Indira Gandhi Med Coll & Res Inst, Dept Microbiol, Pondicherry, India
关键词
Culture; drug susceptibility; laboratory diagnosis; microscopy; molecular techniques; tuberculosis; MYCOBACTERIUM-TUBERCULOSIS; IMMUNOCHROMATOGRAPHIC ASSAY; FLUORESCENCE MICROSCOPY; PULMONARY TUBERCULOSIS; RESISTANT TUBERCULOSIS; RAPID IDENTIFICATION; SYSTEM; SPUTUM; COMPLEX; RIFAMPIN;
D O I
10.4103/ijmm.IJMM_16_204
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
There have been rapid technological advances in the detection of Mycobacterium tuberculosis and its drug susceptibility in clinical samples. These include advances in microscopic examination, in vitro culture and application of molecular techniques. The World Health Organization (WHO) has played a large role in evaluating these technologies for their efficacy and feasibility, especially in the developing countries. Amongst these, the Revised National Tuberculosis Control Programme (RNTCP), through its national network of designated microscopy centres and intermediate reference laboratories, has adopted certain technologies that are currently implemented in India. Advances in microscopy technology include fluorescent microscopy using light-emitting diode source, sodium hypochlorite microscopy and vital fluorescent staining of sputum smears. Automation of in vitro culture has markedly reduced the turnaround time (TAT), even in smear-negative samples, and permits simultaneous detection of resistant mutants. Molecular detection of drug resistance has further reduced the TAT, and the cartridge-based nucleic acid amplification test with its performance convenience and rapid results, appears poised to become the future of tuberculosis (TB) diagnosis in all settings, provided the cost of testing is reduced especially for use in private diagnostic settings. This article reviews technologies currently available for the diagnosis of TB, keeping in mind the WHO recommendations and the RNTCP practices. This is a thematic synthesis of data available on diagnosis in literature, preserving the conclusions of the primary studies.
引用
收藏
页码:323 / 331
页数:9
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