The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis.
The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis.
复制标题
DOI：
10.3791/845
复制
发表时间：
2008-08-11
期刊：
影响因子：
--
通讯作者：
Moore, David Aj
中科院分区：
文献类型：
--
作者：
Brady, Mark F;Coronel, Jorge;Moore, David Aj
活动性肺结核（TB）患者每年感染10-15人，因此诊断活动性TB对于治愈患者和预防新感染至关重要。此外，耐多药结核病（MDRTB）的出现意味着必须检测耐药性，以阻止耐药菌株的传播。显微镜观察药物敏感性（MODS）检测是一种低成本、低技术的结核病和耐多药结核病高性能检测工具。MODS测定基于三个原则：1）结核分枝杆菌（MTB）在液体培养基中比在固体培养基上生长得更快2）在液体培养基中的显微镜下MTB生长可以比在固体培养基上等待菌落的肉眼可见的出现更早地检测到，并且该生长是MTB的特征，使其与非典型分枝杆菌或真菌或细菌污染区分开3）药物异烟肼和利福平可被掺入MODS测定中，以允许同时直接检测MDRTB，从而避免了进行间接药物敏感性试验的传代培养的需要。目前的竞争性诊断受到以下因素的阻碍：痰涂片敏感性低、固体培养基培养诊断延迟时间长、现有液体培养基培养方法成本过高以及需要进行传代培养以进行间接药物敏感性试验来检测MDRTB。相比之下，非专利的MODS方法对TB和MDRTB具有高灵敏度，是一种相对快速的培养方法，可同时进行MDRTB的药物敏感性测试，并且可用于资源有限的环境，用于TB和MDRTB的测试不到3美元。
Patients with active pulmonary tuberculosis (TB) infect 10-15 other persons per year, making diagnosing active TB essential to both curing the patient and preventing new infections. Furthermore, the emergence of multidrug resistant tuberculosis (MDRTB) means that detection of drug resistance is necessary for stopping the spread of drug-resistant strains. The microscopic-observation drug-susceptibility (MODS) assay is a low-cost, low-tech tool for high-performance detection of TB and MDRTB. The MODS assay is based on three principles: 1) mycobacterium tuberculosis (MTB) grows faster in liquid media than on solid media 2) microscopic MTB growth can be detected earlier in liquid media than waiting for the macroscopic appearance of colonies on solid media, and that growth is characteristic of MTB, allowing it to be distinguished from atypical mycobacteria or fungal or bacterial contamination 3) the drugs isoniazid and rifampicin can be incorporated into the MODS assay to allow for simultaneous direct detection of MDRTB, obviating the need for subculture to perform an indirect drug susceptibility test. Competing current diagnostics are hampered by low sensitivity with sputum smear, long delays until diagnosis with solid media culture, prohibitively high cost with existing liquid media culture methods, and the need to do subculture for indirect drug susceptibility testing to detect MDRTB. In contrast, the non-proprietary MODS method has a high sensitivity for TB and MDRTB, is a relatively rapid culture method, provides simultaneous drug susceptibility testing for MDRTB, and is accessible to resource-limited settings at just under $3 for testing for TB and MDRTB.