Modern laboratory diagnosis of tuberculosis.
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.
Drobniewski
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FA
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
Caws
M
M
Gibson
A
A
Young
D
D
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
D000995:Antitubercular Agents