title: Modern laboratory diagnosis of tuberculosis.
abstract: One-third of the global population is believed to be infected with bacteria of the Mycobacterium tuberculosis complex, the causative agent of tuberculosis. More than 8 million new cases of tuberculosis occur annually leading to 2 million deaths. Mortality is particularly high in those coinfected with HIV and where the bacteria are multiple-drug-resistant strains--ie, strains resistant to at least isoniazid and rifampicin. Early diagnosis of tuberculosis and drug resistance improves survival and by identifying infectious cases promotes contact tracing, implementation of institutional cross-infection procedures, and other public-health actions. This review addresses significant advances made in the diagnosis of infection, clinical disease, and drug resistance over the past decade. It proposes operational criteria for a modern diagnostic service in the UK (as a model of a low-incidence country) and explores some of the economic issues surrounding the use of these techniques.
authors.affiliation: PHLS Mycobacterium Reference Unit and Department of Infection, Guy's King's and St Thomas' Medical College, King's College Hospital (Dulwich) London, UK. francis.drobniewski@kcl.ac.uk
authors.forename: F A
authors.initials: FA
authors.lastname: Drobniewski
authors.forename: M
authors.initials: M
authors.lastname: Caws
authors.forename: A
authors.initials: A
authors.lastname: Gibson
authors.forename: D
authors.initials: D
authors.lastname: Young
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D007753:Laboratories / Q000592:standards; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000302:isolation & purification / Q000502:physiology; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy; D006113:United Kingdom
chemical_list: D000995:Antitubercular Agents