The Korean Journal of Medicine

  • 제82권3호
  • /
  • Pages.263-268
  • /
  • 2012
  • /
  • 1738-9364(pISSN)
  • /
  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지
DOI QR코드

DOI QR Code

결핵의 새로운 진단법

New Diagnostic Methods for Tuberculosis

  • 임효정 (서울대학교 의과대학 내과학교실 분당서울대학교병원 내과) ;
  • 이재호 (서울대학교 의과대학 내과학교실 분당서울대학교병원 내과)
  • Lim, Hyo-Jeong (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Lee, Jae-Ho (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital)
  • 발행 : 2012.03.01
⟨ 이전 논문 다음 논문 ⟩

초록

Tuberculosis (TB) is one of the most important public issues for its global burden of mortality and morbidity. Rapid diagnosis and treatment of active TB are crucial in effective TB control because of lacking truly effective preventive strategy. In recent decades, drug-resistant TB (DR-TB) has emerged as an expanding threat, prompt and reliable laboratory detection of of DR-TB are urgently needed to limit the spread of them. Recently, nonmolecular and molecular assays has been developed for early detection of active TB with or without detection of drug resistance. Broth-based culture systems are capable of producing positive results in 3 weeks or less and many automated system can be widely used for drug susceptibility test. Nucleic acid amplication (NAA) assays have high specificity and positive predictive value, high sensitivity in smear positive specimens. Line probe assays shows high sensitivity for detecting resistance to rifampin and variables sensitivity for detecting resistance to isoniazid. XpertMTB/RIF assay, an automated rapid PCR device, showed high sensitivity and specificity for TB and rifampin resistance. Although new diagnostic methods can decrease turn-around time with considerable diagnostic accuracy and convenience, they are not a replacement for culture and conventional drug susceptibility test for diagnostic limitation in special situations.

키워드

참고문헌

  1. Aber VR, Allen BW, Mitchison DA, Ayuma P, Edwards EA, Keyes AB. Quality control in tuberculosis bacteriology: 1. Laboratory studies on isolated positive cultures and the efficiency of direct smear examination. Tubercle 1980;61:123-133. https://doi.org/10.1016/0041-3879(80)90001-X
  2. Siddiqi K, Lambert ML, Walley J. Clinical diagnosis of smear-negative pulmonary tuberculosis in low-income countries: the current evidence. Lancet Infect Dis 2003;3:288-296. https://doi.org/10.1016/S1473-3099(03)00609-1
  3. Diagnostic standards and classification of tuberculosis in adults and children: this official statement of the American Thoracic Society and the Centers for Disease Control and Prevention was adopted by the ATS Board of Directors, July 1999: this statement was endorsed by the Council of the Infectious Disease Society of America, September 1999. Am J Respir Crit Care Med 2000;161(4 Pt 1):1376-1395.
  4. Kim S, Park EM, Kwon OJ, et al. Direct application of the PCR restriction analysis method for identifying NTM species in AFB smear-positive respiratory specimens. Int J Tuberc Lung Dis 2008;12:1344-1346.
  5. Park YS, Lee CH, Lee SM, et al. Rapid increase of nontuberculous mycobacterial lung diseases at a tertiary referral hospital in South Korea. Int J Tuberc Lung Dis 2010; 14:1069-1071.
  6. Steingart KR, Henry M, Ng V, et al. Fluorescence versus conventional sputum smear microscopy for tuberculosis: a systematic review. Lancet Infect Dis 2006;6:570-581. https://doi.org/10.1016/S1473-3099(06)70578-3
  7. Marais BJ, Brittle W, Painczyk K, et al. Use of lightemitting diode fluorescence microscopy to detect acid-fast bacilli in sputum. Clin Infect Dis 2008;47:203-207. https://doi.org/10.1086/589248
  8. Minion J, Sohn H, Pai M. Light-emitting diode technologies for TB diagnosis: what is on the market? Expert Rev Med Devices 2009;6:341-345. https://doi.org/10.1586/erd.09.26
  9. Anthony RM, Kolk AH, Kuijper S, Klatser PR. Light emitting diodes for auramine O fluorescence microscopic screening of Mycobacterium tuberculosis. Int J Tuberc Lung Dis 2006;10:1060-1062.
  10. Strategic and technical advisory group on tuberculosis (STAG-TB). Report of the Ninth meeting. World Health Organization (WHO). 2009.
  11. Joint Committee for the Development of Korean Guidelines for Tuberculosis; Korea Centers of Disease Control and Prevention. Korean Guidelines for Tuberculosis. 2011.
  12. Sharp SE, Lemes M, Sierra SG, Poniecka A, Poppiti RJ Jr. Lowenstein-Jensen media: no longer necessary for mycobacterial isolation. Am J Clin Pathol 2000;113:770-773. https://doi.org/10.1309/JHDD-1HF4-2KCN-7ANP
  13. Kanchana MV, Cheke D, Natyshak I, Connor B, Warner A, Martin T. Evaluation of the BACTEC MGIT 960 system for the recovery of mycobacteria. Diagn Microbiol Infect Dis 2000;37:31-36. https://doi.org/10.1016/S0732-8893(99)00151-0
  14. Sanders CA, Nieda RR, Desmond EP. Validation of the use of Middlebrook 7H10 agar, BACTEC MGIT 960, and BACTEC 460 12B media for testing the susceptibility of Mycobacterium tuberculosis to levofloxacin. J Clin Microbiol 2004;42:5225-5228. https://doi.org/10.1128/JCM.42.11.5225-5228.2004
  15. Palomino JC, Traore H, Fissette K, Portaels F. Evaluation of Mycobacteria Growth Indicator Tube (MGIT) for drug susceptibility testing of Mycobacterium tuberculosis. Int J Tuberc Lung Dis 1999;3:344-348.
  16. Palaci M, Ueki SY, Sato DN, Da Silva Telles MA, Curcio M, Silva EA. Evaluation of mycobacteria growth indicator tube for recovery and drug susceptibility testing of Mycobacterium tuberculosis isolates from respiratory specimens. J Clin Microbiol 1996;34:762-764.
  17. Moore DA, Evans CA, Gilman RH, et al. Microscopicobservation drug-susceptibility assay for the diagnosis of TB. N Engl J Med 2006;355:1539-1550. https://doi.org/10.1056/NEJMoa055524
  18. Wilson ML. Recent advances in the laboratory detection of Mycobacterium tuberculosis complex and drug resistance. Clin Infect Dis 2011;52:1350-1355. https://doi.org/10.1093/cid/cir146
  19. Minion J, Leung E, Menzies D, Pai M. Microscopicobservation drug susceptibility and thin layer agar assays for the detection of drug resistant tuberculosis: a systematic review and meta-analysis. Lancet Infect Dis 2010;10:688-698. https://doi.org/10.1016/S1473-3099(10)70165-1
  20. Montoro E, Lemus D, Echemendia M, Martin A, Portaels F, Palomino JC. Comparative evaluation of the nitrate reduction assay, the MTT test, and the resazurin microtitre assay for drug susceptibility testing of clinical isolates of Mycobacterium tuberculosis. J Antimicrob Chemother 2005;55:500-505. https://doi.org/10.1093/jac/dki023
  21. Martin A, Palomino JC, Portaels F. Rapid detection of ofloxacin resistance in Mycobacterium tuberculosis by two low-cost colorimetric methods: resazurin and nitrate reductase assays. J Clin Microbiol 2005;43:1612-1616. https://doi.org/10.1128/JCM.43.4.1612-1616.2005
  22. Centers for Disease Control and Prevention (CDC). Updated guidelines for the use of nucleic acid amplification tests in the diagnosis of tuberculosis. MMWR Morb Mortal Wkly Rep 2009;58:7-10.
  23. Morgan M, Kalantri S, Flores L, Pai M. A commercial line probe assay for the rapid detection of rifampicin resistance in Mycobacterium tuberculosis: a systematic review and meta-analysis. BMC Infect Dis 2005;5:62. https://doi.org/10.1186/1471-2334-5-62
  24. Ling DI, Zwerling AA, Pai M. GenoType MTBDR assays for the diagnosis of multidrug-resistant tuberculosis: a metaanalysis. Eur Respir J 2008;32:1165-1174. https://doi.org/10.1183/09031936.00061808
  25. Bwanga F, Hoffner S, Haile M, Joloba ML. Direct susceptibility testing for multi drug resistant tuberculosis: a meta-analysis. BMC Infect Dis 2009;9:67. https://doi.org/10.1186/1471-2334-9-67
  26. Hillemann D, Rüsch-Gerdes S, Richter E. Feasibility of the GenoType MTBDRsl assay for fluoroquinolone, amikacincapreomycin, and ethambutol resistance testing of Mycobacterium tuberculosis strains and clinical specimens. J Clin Microbiol 2009;47:1767-1772. https://doi.org/10.1128/JCM.00081-09
  27. Boehme CC, Nabeta P, Hillemann D, et al. Rapid molecular detection of tuberculosis and rifampin resistance. N Engl J Med 2010;363:1005-1015. https://doi.org/10.1056/NEJMoa0907847

피인용 문헌

  1. A Systematic Review on the Effectiveness of Detection ofM. tuberculosisand Rifampin Resistance Using Xpert MTB/RIF vol.17, pp.2, 2012, https://doi.org/10.5145/acm.2014.17.2.42
  2. 마이코박테리아 검출을 위하여 MGIT 양성 신호를 보인 세균에 오염된 검체 재처리 과정의 효율성 평가 vol.51, pp.2, 2012, https://doi.org/10.15324/kjcls.2019.51.2.171