The new diagnostic mycobacteriology laboratory

Abstract

Recent surveys in the USA show that many mycobacteriology laboratories continue to use less-than-optimum culture and susceptibility testing methods. This seems to be true for European countries as well. The past few years have brought significant changes to the clinical tuberculosis laboratory. High-performance liquid chromatography and direct detection of acid-fast bacilli in clinical specimens aim at the same goal: increased sensitivity and specificity of the diagnostic approach and reduction of turnaround time. This review outlines a brief comparison between contemporary traditional methods and the latest developments in the direct detection of acid-fast bacilli. If patient care and public health are always considered paramount, regardless of admission time, hospital type, etc., the current concept of services has several shortcomings. One way to manage this situation is to sort and allocate specimens according to a system of priorities. There is a growing realization that no single method by itself is the best. To streamline the best choice for laboratory diagnosis, an additional dynamic acid-fast network is presented: 'Point-of-Care,' 'Fast Track,' and 'Specialty' laboratories. The physician interacts with all three types of laboratories, so ongoing communication between the physician and the laboratory is essential. Laboratorians must work together in the formation of this dynamic acid-fast network to improve service rendered for our patients.

A systematic review of rapid diagnostic tests for the detection of tuberculosis infection

“…[29][30][31] In resource-poor countries, TBLN is usually a clinical diagnosis supported by a positive tuberculin skin test (TST). The laboratory diagnosis depends on the detection of M. TB in pus, aspirates or biopsies from lymph nodes.…”

Molecular Techniques for Identification of Species of the Mycobacterium tuberculosis Complex: The use of Multiplex PCR and an Adapted HPLC Method for Identification of Mycobacterium bovis and Diagnosis of Bovine Tuberculosis

“…There is a growing perception that no single method is sufficient for detecting all cattle infected with BTB (Salfinger et al, 1994); therefore, a multidisciplinary approach must be employed, based on currently available methods. Some of the diagnostic methods and combinations of methods that are regularly used for diagnosing BTB are shown in Figure 1.…”

Rapid drug susceptibility testing of Mycobacterium tuberculosis using conventional solid media

“…Besides the increased incidence of tuberculosis, the emergence of drug-resistant strains, especially in high-risk groups [2,3], implies a considerable threat to public health [4]. Thus, it is extremely important to determine the susceptibility of individual Mycobacterium tuberculosis strains as rapidly as possible [5,6]. In recent years, efforts have been made to shorten the time of susceptibility testing for M. tuberculosis.…”