2018, Number 2
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Rev Med Inst Mex Seguro Soc 2018; 56 (2)
MGIT and other methods for diagnosing tuberculosis in a private hospital system with low incidence
Guajardo-Lara CE, Saldańa-Ramírez MI, Hernández-Galván NN, Dimas-Adame MA, Ayala-Gaytán JJ, Valdovinos-Chávez SB
Language: Spanish
References: 23
Page: 158-162
PDF size: 326.60 Kb.
ABSTRACT
Background: Tuberculosis (TB) is still a threat to public
health; in 2014 caused 1.5 million deaths worldwide; in
hospitals where the prevalence of TB is low, it is
appropriate to evaluate the effectiveness of tests to
diagnose it.
Methods: We reviewed reports of airway clinical
specimens sent for studies of tuberculosis to the
microbiology laboratory from Tec Salud System private
hospitals (400 beds) in the metropolitan area of
Monterrey, NL, from May 2012 to December 2015. In
conjunction with Ziehl-Neelsen (ZN) stain, and solid
Lowenstein-Jensen medium (LJ), our laboratory resources
also include fluorescent LED microscopy (Carl Zeiss
Microscopy Products), MGIT 320 (Mycobacteria Growth
Indicator Tube liquid culture detection system, Becton
Dickinson), and recently incorporated a real-time PCR
system the Xpert MTB/RIF test (Cepheid, Sunnyvale, CA).
Results: In 731 respiratory specimens from 510 patients,
M. tuberculosis was isolated from 78 samples belonging to
50 patients on LJ and MGIT LJ 42 (84%) and MGIT 49,
(98%) of the samples. From 41 patients identified, 26
(63.4%) were positive to fluorescein, and 25 (60.9%) with
Ziehl-Neelsen stain. Real time PCR (Xpert TB) was
positive in 13 out of 17 patient-airway samples (76.4%).
Conclusions: Usefulness of liquid culture (MGIT) and
solid culture (LJ) is shown; the first can significantly cut
incubation times.
REFERENCES
World Health Organization. Global Report Tuberculosis Report 2015, 20th edition, WHO. Geneva, Switzerland: WHO; 2015.
World Health Organization. Systematic screening for active tuberculosis. Principles and recommendations. Geneva, Switzerland: WHO; 2013.
Flores-Ibarra AA, Ochoa-Vázquez MD, Sánchez-Tec GA. Estrategias diagnósticas aplicadas en la Clínica de Tuberculosis del Hospital General Centro Médico Nacional la Raza. Rev Med Inst Mex Seguro Soc. 2016;54(1):122-7.
World Health Organization. Use of liquid TB culture and drug susceptibility testing (DST) in low and medium income settings. Summary report of the expert group meeting on the use of liquid culture media. Geneva, Switzerland: WHO; 2007.
World Health Organization. Fluorescent light-emitting diode (LED) microscopy for diagnosis of tuberculosis. Policy statement. Geneva, Switzerland: WHO; 2011.
World Health Organization. Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB/RIF system. Geneva, Switzerland: WHO; 2011.
Centers for Disease Control. Laboratory manual of mycobacteria. Taipei, Taiwan: Centers for Disease Control; 2004.
Fitzgerald DW, Sterling TR, Haas DW. Mycobacterium tuberculosis. En: Bennett JE, Dolan R, Blaser MJ, Eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2015: chap 251. pp. 2787- 818.
Cruciani M, Scarparo C, Malena M, Bosco O, Serpelloni G, Mengoli C. Meta-analysis of BACTEC MGIT 960 and BACTEC 460 TB, with or without solid media, for detection of mycobacteria. J Clin Microbiol. 2004;42:2321-5.
Tyrrell FC, Budnick GE, Elliott T, Gillim-Ross L, Hildred MV, Mahlmeister P, et al. Probability of negative Mycobacterium tuberculosis complex cultures based on time to detection of positive cultures: a multicenter evaluation of commercialbroth- based culture systems. J Clin Microbiol. 2012;50:3275-82.
Moreira-Ada S, Huf G, Vieira MA, Costa PA, Aguiar F, Marsico AG, et al. Liquid vs. solid culture medium to evaluate proportion and time to change in management of suspects of tuberculosis - A pragmatic randomized trial in secondary and tertiary health care units in Brazil. PLoS One. 2015;10(6):e0127588.
Kim CH, Hyun IG, Hwang YI, Kim DG, Lee CY, Lee MG, et al. Identification of Mycobacterium tuberculosis and rifampin resistance in clinical specimens using the Xpert MTB/RIF assay. Ann Clin Lab Sci. 2015;45:32-8. 2
Yu MC, Chien HY, Wu M, Huang W, Kuo Y, Yu F, Jou R. Evaluation of the rapid MGIT TBc identification test for culture confirmation of Mycobacterium tuberculosis complex strain detection. J Clin Microbiol. 2011;49:802-7.
Reid MJ, Shah NS. Approaches to tuberculosis screening and diagnosis in people with HIV in resource-limited settings. Lancet Infect Dis. 2009;9:173-84.
World Health Organization. Framework for implementing new tuberculosis diagnostics. Geneva, Switzerland: WHO; 2010.
Sohn H, Aero AD, Menzies D, Behr M, Schwartzman K, Alvarez GG, et al. Xpert MTB/RIF testing in a low tuberculosis incidence, high-resource setting: limitations in accuracy and clinical impact. Clin Infect Dis. 2014;58:970-6.
Salfinger M. Molecular laboratory testing for tuberculosis: innovators, early adopters, or laggards? Clin Infect Dis. 2014;58:977-9.
Pinyopornpanish K, Chaiwarith R, Pantip C, Keawvichit R, Wongworapat K, Khamnoi P, et al. Comparasion of Xpert MTB/RIF assay and the conventional sputum microscopy in detecting Mycobacterium tuberculosis in Northern Thailand. Tuberc Res Treat. 2015;571782:1-6.
Marlowe EM, Novak-Weekley SM, Cumpio J, Sharp SE, Momeny MA, Babst A, et al. Evaluation of the Cepheid Xpert MTB/RIF assay for direct detection of Mycobacterium tuberculosis complex in respiratory specimens. J Clin Microbiol. 2011;49:1621-3.
Centers for Disease Control and Prevention (CDC). Updated guidelines for the use of nucleic acid amplification tests in the diagnosis of tuberculosis. MMWR Morb Mortal Wkly Rep. 2009;58:7-10.
Taylor Z, Nolan CM, Blumberg HM; American Thoracic Society; Centers for Disease Control and Prevention; Infectious Diseases Society of America. Controlling tuberculosis in the United States. Recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of America. MMWR Morb Mortal Wkly Rep. 2005;54(RR-12):1-81.
Haddad MB, Mitruka K, Oeltmann JE, Johns EB, Navin TR. Characteristics of tuberculosis cases that started outbreaks in the United States, 2002-2011. Emerg Infect Dis. 2015;21:508-10.
Salinas JL, Mindra G, Haddad MB, Pratt R, Price SF, Langer AJ. Leveling of Tuberculosis incidence - United States, 2013-2015. MMWR Morb Mortal Wkly Rep. 2016;65:273-8.