There’s
an interesting article in Biotechniques, looing at progress with the World
Health Organizations tuberculosis eradication strategy. Here is an extract:
Active
TB infection is defined by the presence of clinical symptoms, such as cough,
fever and weight loss, as well as positive microbial cultures for acid-fast
bacteria. Due to widespread dissemination throughout the body, patient
infection is defined as pulmonary or extra-pulmonary TB infection.
Globally,
3.4% of all new cases, and 18% of previously treated TB patients, possess
drug-resistant bacteria. Therefore, active TB infection is also classified by
the degree to which the bacteria are resistant to antibiotic combinations.
Quick identification of antibiotic resistance is key in preventing the
development of further antibiotic resistance and restricting the morbidity
associated with active TB infection. Furthermore, rapid initiation of treatment
helps to limit the spread.
Early
diagnosis and universal drug susceptibility testing are considered two of the
main priorities of the WHO’s End TB Strategy. The current ‘gold standard’ rapid
diagnostic test for TB is Xpert MTB/RIF (Cepheid Inc., CA, USA). The diagnostic
utilizes real-time PCR technologies via a cartridge-based system. Samples of
varying types, including sputum, lymph node aspirate and cerebrospinal fluid,
can be taken to diagnose both pulmonary and extrapulmonary infection, with the
results detecting both the bacteria and ripanfacin-resistance – the surrogate
marker for multi-drug resistant TB. Xpert MTB/RIF is cost-effective and also
has proven utility for targeted testing of individuals, for example in prisons
where TB burden and risk of cross-infection is high.
Posted by Dr. Tim Sandle, Pharmaceutical Microbiology Resources (http://www.pharmamicroresources.com/)
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