DOI QR코드

DOI QR Code

Mycobacterium tuberculosis DNA Detection and Molecular Drug Susceptibility Test in AFB-stained Sputum Slides

  • Jung, Dongju (Department of Biomedical Laboratory Science, College of Life and Health Sciences, Hoseo University) ;
  • Lee, Hyeyoung (Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University) ;
  • Park, Sangjung (Department of Biomedical Laboratory Science, College of Life and Health Sciences, Hoseo University)
  • Received : 2016.03.22
  • Accepted : 2016.03.29
  • Published : 2016.03.31

Abstract

Tuberculosis (TB) remains an unsolved community health problem since identification of its causing microorganism called Mycobacterium tuberculosis (MTB) by Robert Koch in 1882. Annually, eight million TB cases are newly reported and 2~3 million patients die from TB. Pulmonary TB is highly infectious and untreated pulmonary TB patients are believed to infect >10 people in a year. The conventional methods for diagnosis of TB are chest X-ray and isolation of the causing microorganisms from patient specimens. Screening of TB is conducted with smeared sputum in slides, and TB is confirmed by identification of MTB in cultured specimens. One of the fatal pitfalls of screening detection for smeared sputum is that it is impossible to distinguish MTB and other acid-fast bacilli (AFB) because they are stained equally with Ziehl-Neelsen (ZN) stain. Culture of MTB is the most reliable method for diagnosis of TB but it takes 4~8 weeks. In this report, we suggest a fast and highly-reliable MTB detection method that distinguishes AFB in sputum samples. Purified DNA from the AFB stained slide samples offered by The Korean Institute of Tuberculosis were used to detect infected MTB in patients. PCR, real-time PCR and reverse blot hybridization assay (REBA) methods were applied to purified DNA. Conclusively, the real-time PCR method was confirmed to produce high sensitivity and we were able to further detect drug-resistant MTB with REBA.

Keywords

References

  1. Bang H, Park S, Hwang J, Jin H, Cho E, Kim DY, Song T, Shamputa IC, Via LE, Barry CE 3rd, Cho SN, Lee H. Improved rapid molecular diagnosis of multidrug-resistant tuberculosis using a new reverse hybridization assay, REBA MTB-MDR. J Med Microbiol. 2011. 60: 1447-1454. https://doi.org/10.1099/jmm.0.032292-0
  2. Bates JH. Diagnosis of tuberculosis. Chest. 1979. 76: 757-763. https://doi.org/10.1378/chest.76.6.757
  3. Cho E, Shamputa IC, Kwak HK, Lee J, Lee M, Hwang S, Jeon D, Kim CT, Cho S, Via LE, Barry CE 3rd, Lee JS. Utility of the REBA $MTB-Rifa^{(R)}$ assay for rapid detection of rifampicin resistant Mycobacterium tuberculosis. BMC infect Dis. 2013. 13: 478. https://doi.org/10.1186/1471-2334-13-478
  4. Dye CS, Schelle P, Dolin V, Pathania, Raviglione MC. Global burden of tuberculosis: estimated incidence, prevalence, and mortality by country. JAMA. 1999. 282: 677-686. https://doi.org/10.1001/jama.282.7.677
  5. Frieden TR, Sterling T, Pablos-Mendez A, Kilburn JO, Cauthen GM, Dooley SW. The emergence of drug-resistant tuberculosis in New York City. N Engl J Med. 1993. 25: 521-526.
  6. Gous N, Scott LE, Khan S, Reubenson G, Coovadia A, Stevens W. Diagnosing childhood pulmonary tuberculosis using a single sputum specimen on Xpert MTB/RIF at point of care. S Afr Med J. 2015. 105: 1044-1048. https://doi.org/10.7196/SAMJ.2015.v105i12.8585
  7. Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, Holland SM, Horsburgh R, Huitt G, Iademarco MF, Iseman M, Olivier K, Ruoss S, von Reyn CF, Wallace RJ Jr, Winthrop K. Infectious Disease Society of America. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007. 175: 367-416. https://doi.org/10.1164/rccm.200604-571ST
  8. Heo R, Kim YS. The rapid drug susceptibility testing of Mycobacterium tuberculosis by $GenoType^{(R)}$ MTBDRplus in contaminated specimen. Biomed Sci Lett. 2013. 19: 303-337.
  9. Kent P, Kubica G. Public Health mycobacteriology. A guide for the level III laboratory. US Public Health Service. Washington DC. 1985: 57-68.
  10. Korean Institute of Tuberclusosis. Current situation of MDR-TB and XDR-TB in Korea. 2009.
  11. Kumar V, Abbas Ak, Fausto N, Mitchell RN. Bobbins Basic Pathology (8th Ed): Saunders Elsevier. 2007.
  12. Lee YS, Kang MR, Jung H, Choi SB, Jo KW, Shim TS. Performance of REBA MTB-XDR to detect extensively drugresistant tuberculosis in an intermediate-burden country. J Infect Chemother. 2015. 21: 346-351. https://doi.org/10.1016/j.jiac.2014.12.009
  13. Lew WT, Lee EG, Kwon DW, Kim SJ, Hong YP, Kim JB. The fate of intractable tuberculosis cases under national tuberculosis programme. Tuberc and Resp Dis. 1995. 42: 11-18. https://doi.org/10.4046/trd.1995.42.1.11
  14. Moore M, Onorato IM, McCray E, Castro KG. Trends in drugresistant tuberculosis in the United States, 1993-1996. JAMA. 1997. 10: 833-837.
  15. Munkhdelger J, Mia-Jan K, Lee D, Park S, Kim S, Choi Y, Wang H, Jeon BY, Lee H, Park KH. Performance of quantitative real-time PCR for detection of tuberculosis in granulomatous lymphadenitis using formalin-fixed paraffin-embedded tissue. J Exp Biomed Sci. 2013. 19: 153-157.
  16. Pai M, Schito M. Tuberculosis diagnostics in 2015: landscape, priorities, needs, and prospects. J Infect Dis. 2015. 211: S21-28. https://doi.org/10.1093/infdis/jiu803
  17. Quy HT, Lan NT, Borgdorff MW, Grosset J, Linh PD, Tung LB, van Soolingen D, Raviglione M, Co NV, Broekmans J. Drug resistance among failure and relapse cases of tuberculosis: is the standard re-treatment regimen adequate? Int J Tuberc Lung Dis. 2003. 7: 631-636.
  18. Tenover FC, Crawford JT, Huebner RE, Geiter LJ, Horsburgh CR, Good RC. The resurgence of tuberculosis: is your laboratory ready? J Clin Microbiol. 1993. 31: 767-770.
  19. WHO. Global Tubercluosis control report. 2010.
  20. Woods GL. Molecular techniques in mycobacterial detection. Arch Pathol Lab Med. 2001. 125: 122-126.