Diagnosis and detection of drug-resistant strains of M. tuberculosis. Clearinghouse, P.O. Box 6003, Rockville, MD 20849-6003. 800-458-5231 ext. 5023.

Important note: Information in this article was accurate in 1995. The state of the art may have changed since the publication date.

Diagnosis and detection of drug-resistant strains of M. tuberculosis. Clearinghouse, P.O. Box 6003, Rockville, MD 20849-6003. 800-458-5231 ext. 5023.

AIDS Clin Care. 1995 Apr;7(4):27-9, 36. Unique Identifier : AIDSLINE AIDS/95700180
Ferraro MJ; Klietmann, W; Lee JT; Massachusetts General Hospital, Clinical Laboratories, Boston,; MA.

Abstract: Factors contributing to the recent upswing in tuberculosis (TB) cases in the United States include the shifting of management of TB cases from specialized hospital units to lesser-equipped outpatient settings; reduced medical school teaching of TB-related issues; large-scale immigration from regions endemic for TB; and the homelessness and AIDS cases that have created a pocket of disease in high-risk populations. At least 33 percent of current cases can be attributed to new rather than reactivated infection, and many of these are caused by the ever-increasing number of drug-resistant strains. Multidrug-resistant TB has a higher overall fatality rate and disproportionately affects immunocompromised and HIV-infected individuals. Clearly, expedient diagnosis is important in controlling the spread of tuberculosis. Sputum samples, evaluated first by direct microscopic evaluation (smear), are visualized with either the easily detected acid-fast fluorochrome dye auramine O, or the more specific Ziehl-Neelsen stain. Specimens are cultured on either solid media (Lowenstein-Jensen slant), or are grown in a liquid medium, such as the BACTEC automated radiometric system. Next, biochemical or nucleic acid probe testing is used to identify various strains. Isolates are tested for resistance to commonly used antituberculosis drugs, often by using the new method of susceptibility testing in liquid broth rather than the traditional agar dilution method. Clinical laboratories await FDA approval of two new methods employing hybridization with rRNA genes or polymerase chain reaction (PCR) that will further speed up diagnosis of TB.

Keywords: Antitubercular Agents/PHARMACOLOGY/*THERAPEUTIC USE Disease Outbreaks Drug Resistance, Microbial Human Microbial Sensitivity Tests Mycobacterium tuberculosis/*DRUG EFFECTS/ISOLATION & PURIF Tuberculosis/DIAGNOSIS/DRUG THERAPY/EPIDEMIOLOGY NEWSLETTER ARTICLE

951130
M95B0926

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