New Diagnostic Methods for Mycobacterium Tuberculosis Infection

Dong Ho Shin

doi:10.5124/jkma.2006.49.9.773

J Korean Med Assoc > Volume 49(9); 2006 > Article

Shin: New Diagnostic Methods for Mycobacterium Tuberculosis Infection

Special Issue

Tuberculosis

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2006; 49(9): 773-780.

Published online: September 30, 2006

DOI: http://dx.doi.org/10.5124/jkma.2006.49.9.773

New Diagnostic Methods for Mycobacterium Tuberculosis Infection

Dong Ho Shin, MD

Department of Internal Medicine, Hanyang University College of Medicine, Korea. shindh@hanyang.ac.kr

Abstract

Rapid and accurate diagnosis of Mycobacterium tuberculosis in symptomatic patients is important for the global tuberculosis control strategies. Despite the enormous global burden of TB and the overall low rates of case detection worldwide, conventional diagnostic approaches have relied on tests that have several major limitations until recently, and standard treatment regimens have not changed for more than 30 yr. Recently remarkable progress in the basic science of immunology and molecular biology is ongoing to upgrade the speed and quality of diagnostic service and probably the strategy of the treatment of tuberculosis. In this review, we focus on strengths and limitations of newer tests that are available for the diagnosis of latent and active tuberculosis and the rapid detection of drug resistance, specifically, tests to measure of IFN-γ released from T-cell by stimulation with M. tuberculosis specific antigens, tests to amplify the nucleic acid for identification of M. tuberculosis complex, and rapid tests to detect drug resistance.

Diagnosis; Mycobacterium tuberculosis; Drug resistance

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Figure 1

Strip layout of line probe assay for mycobacterium (INNO-LiPA Rif-TB. by Innogenetics)

Figure 2

Overview of phage amplification assays (11)

Figure 3

Overview of luciferase reporter phage (LRP) assays (11)

Table 1

Comparison of Tuberculin Skin Test (TST) and RD1-based IFN-γ assays (4)

Table 2

Percentage sensitivity and specificity of nucleic-acid amplification tests in different clinical samples (10)

Amplicor, Amplicor Mycobacterium Tuberculosis Test (Roche Diagnostic Systems Inc, New Jersey, USA); AMTD, Amplified Mycobacterium Tuberculosis Direct Test (Gen-Probe, California, USA); BD Probe Tec, BD Probe Tec ET Direct TB System (Becton Dickinson, Sparks, Maryland, USA); PCR, polymerase chain reaction.