Comparative Study of the Sensitivity of Different Diagnostic Methods for the Laboratory Diagnosis of Buruli Ulcer Disease

Abstract

Across all subgroups, PCR had the highest sensitivity. PCR assessment of 3-mm punch biopsy tissue specimens proved to be the best diagnostic tool for nonulcerative lesions, and PCR assessment of swab samples was the best diagnostic tool for ulcerative lesions. For monitoring of antimycobacterial treatment success within controlled trials, however, only culture is appropriate.

A Genotypic Approach for Detection, Identification, and Characterization of Drug Resistance in Mycobacterium ulcerans in Clinical Samples and Isolates from Ghana

“…5 Especially for clinical management decisions, whole-genome extracts constitute a better diagnostic target to obtain rapid results. In our study, analysis of cultured isolates yielded definite sequencing results for rpoB and rpsL genes in > 80%, whereas the number of definite results obtained from whole-genome extracts was significantly lower (< 40% for rpoB and rpsL genes).…”

“…Mycobacterial cultures were subjected to a confirmatory IS2404 PCR. 3,5,[18][19][20][21] Samples subjected to sequence analysis. Suspensions of IS2404 PCR confirmed M. ulcerans cultures ( N = 87) dissolved in 700 μL Cell Lysis Solution (Qiagen, Hilden, Germany ) followed by inactivation at 80°C for 20 minutes, and IS2404 PCR-positive whole-genome extracts (total of 156 genome extracts) derived from swab ( N = 68) and tissue samples ( N = 88) were subjected to sequence analysis of rpoB and rpsL genes at the Department of Infectious Diseases and Tropical Medicine, University of Munich (DITM).…”

“…However, non-standardized regimens of RMP and/or SM were also used as concomitant treatment before or after surgical interventions before 2006. [3][4][5] Although effective and in many aspects advantageous over surgery, introduction of antimycobacterial treatment poses new challenges for the management of BUD. 1 As is well-known from tuberculosis and leprosy, antimycobacterial treatment is prone to the development of drug resistance.…”

Buruli ulcer: wound care and rehabilitation

“…26 This has an average sensitivity of ~50% (29%-78%). [27][28][29] Higher sensitivity is achieved with surgical samples, being larger, but minimally invasive techniques are required to obtain samples for laboratory confirmation. Microscopic examination has a high specificity of up to 96.6%; 28 skin infection with other mycobacteria is uncommon in rural areas.…”

“…28 In addition to its low sensitivity, the main drawback with culture as a diagnostic technique is the time it takes to obtain a positive result. This constitutes a challenge for both initiating antibiotic therapy and knowing whether infection has been eliminated.…”