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Rapid detection of multidrug-resistant tuberculosis
M Goyal1, R J Shaw, D K Banerjee
1Dept of Respiratory Medicine, Imperial College School of Medicine at St Mary's, London, UK.
The European Respiratory Journal
|May 1, 1997
Summary
Rapid molecular genetic tools quickly identified multidrug-resistant tuberculosis (MDR-TB) strains in HIV-positive patients. This allows for prompt treatment and infection control to prevent nosocomial spread of MDR-TB.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Molecular Genetics
Background:
- Multidrug-resistant tuberculosis (MDR-TB) transmission is a significant hospital infection control challenge, especially in co-infected human immunodeficiency virus (HIV) patients.
- Rapid identification of MDR-TB strains is crucial for effective patient management and preventing outbreaks.
Purpose of the Study:
- To evaluate the utility of molecular genetic tools for the rapid assessment of multidrug-resistant tuberculosis (MDR-TB) in potentially infected patients.
- To quickly identify MDR-TB strains and monitor potential nosocomial spread.
Main Methods:
- Polymerase chain reaction (PCR) was used to amplify genetic loci associated with rifampicin resistance (rpoB) and strain-specific polymorphisms (direct repeat (DR) region) directly from clinical samples.
- Drug resistance was detected using a commercial kit and confirmed by sequencing; strain typing was performed using spoligotyping.
Main Results:
- In one HIV-positive patient with suspected MDR-TB, infection with a MDR strain identical to a known index case was confirmed within 48 hours.
- A second patient, also HIV-positive, tested positive for Mycobacterium tuberculosis but with a rifampicin-sensitive strain.
Conclusions:
- PCR-based molecular genetic tools, including strain-typing and rifampicin resistance identification, are effective for rapid diagnosis of MDR-TB.
- Prompt identification and monitoring of MDR-TB transmission enable early clinical intervention and effective infection control measures, preventing future outbreaks.