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Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
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Non-Tuberculosis mycobacterium speciation using HPLC under Revised National TB Control Programme (RNTCP) in India.

G Sebastian1,2, S B Nagaraja3, T Vishwanatha4

  • 1Bharathiar University, Coimbatore, India.

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Non-Tuberculous Mycobacteria (NTM) are increasingly significant pathogens. High-performance liquid chromatography (HPLC) effectively identified 95% of NTM isolates to the species level, highlighting its importance for diagnosis in TB control programs.

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Area of Science:

  • Microbiology
  • Clinical Diagnostics
  • Public Health

Background:

  • Non-Tuberculous Mycobacteria (NTM) are environmental bacteria with growing clinical relevance.
  • Data on NTM prevalence within the Revised Tuberculosis Control Programme (RNTCP) is limited.
  • Accurate identification and speciation of NTM are crucial due to their potential to cause disease.

Purpose of the Study:

  • To determine the prevalence and speciation of NTM isolates from samples processed under the RNTCP.
  • To evaluate the utility of High-Performance Liquid Chromatography (HPLC) for NTM identification and speciation.

Main Methods:

  • A cross-sectional study was conducted at five RNTCP-accredited culture and drug susceptibility testing laboratories.
  • AFB-positive, ICT-negative samples were analyzed for NTM identification and speciation using HPLC.
  • A total of 266 isolates were initially processed, with 164 having a second sample available for speciation.

Main Results:

  • HPLC identified NTM species in 95% of the 164 isolates analyzed.
  • The most common NTM identified were Mycobacterium chelonae (26.8%) and Mycobacterium fortuitum (12.8%).
  • Mycobacterium tuberculosis complex was identified in 9% of isolates, alongside other NTM species.

Conclusions:

  • NTM identification and speciation are not routinely performed within the current TB control program.
  • HPLC demonstrated high efficacy in identifying NTM to the species level, identifying 10 different species.
  • The speciation of NTM using HPLC should be prioritized in TB reference laboratories for accurate diagnosis and management of NTM-related diseases.