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Related Experiment Videos

[Mycobacteria--methods to meet the CDC guidelines].

N Yamane1

  • 1Department of Laboratory Medicine, Faculty of Medicine, University of the Ryukyus, Okinawa-pref.

Rinsho Byori. the Japanese Journal of Clinical Pathology
|August 6, 1999
PubMed
Summary
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Rapid laboratory testing for Mycobacterium tuberculosis is crucial. New methods approach CDC guidelines, but faster isolation and identification are needed for timely tuberculosis diagnosis.

Area of Science:

  • Microbiology
  • Clinical Diagnostics
  • Infectious Diseases

Background:

  • The Centers for Disease Control and Prevention (CDC) issued guidelines in 1994 for rapid laboratory testing of Mycobacterium tuberculosis.
  • Current Japanese laboratory practices struggle to meet the CDC's 10-14 day target for M. tuberculosis isolation and identification, partly due to the non-applicability of the radiometric Bactec 460 system.

Purpose of the Study:

  • To evaluate new nonradiometric mycobacterial culture systems for M. tuberculosis detection.
  • To assess a novel microdilution test method for determining minimum inhibitory concentrations (MICs) of M. tuberculosis.
  • To determine how closely developed procedures align with CDC guidelines for tuberculosis testing.

Main Methods:

  • Evaluation of newly developed nonradiometric, automated or semiautomated mycobacterial culture systems using Middlebrook 7H9 broth.

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  • Application of a developed microdilution test method for quantitative MIC determination.
  • Comparison of obtained results against CDC guidelines for smear reporting, isolation/identification, and susceptibility testing.

    • Main Results:

    • Acid-fast bacillus smear results can be reported within 24 hours.
    • Newly developed culture systems report positive results in a mean of 17-20 days, falling 3-6 days behind the CDC's 10-14 day goal for isolation and identification.
    • The developed microdilution method provides quantitative MICs for M. tuberculosis within 7 days of incubation, meeting the CDC's 15-30 day guideline for susceptibility testing.

    Conclusions:

    • The developed procedures closely align with CDC guidelines, with the primary gap being the time required for M. tuberculosis isolation and identification.
    • Further advancements in culture media supporting rapid mycobacterial growth and technologies for detecting attenuated growth are essential to fully meet CDC guidelines.
    • Achieving rapid detection is the key remaining challenge for comprehensive, guideline-compliant tuberculosis laboratory testing.