title: Advances in rapid diagnosis of tuberculosis disease and anti-tuberculous drug resistance.
abstract: Rapid diagnosis of tuberculosis (TB) and multidrug-resistant (resistance to at least rifampin and isoniazid) Mycobacterium tuberculosis (MDR-TB) is one of the cornerstones for global TB control as it allows early epidemiological and therapeutic interventions. The slow growth of the tubercle bacillus is the greatest obstacle to rapid diagnosis of the disease. However, considerable progress has recently been made in developing novel diagnostic tools, especially molecular methods (commercial and 'in-house'), for direct detection in clinical specimens. These methods, based on nucleic acid amplification (NAA) of different targets, aim to identify the M. tuberculosis complex and detect the specific chromosome mutations that are most frequently associated with phenotypic resistance to multiple drugs. In general, commercial methods are recommended since they have a better level of standardization, reproducibility and automation. Although some aspects such as cost-efficiency and the appropriate setting for the implementation of these techniques are not yet well established, organizations such as the WHO are strongly supporting the implementation and universal use of these new molecular methods. This chapter summarizes current knowledge and the available molecular methods for rapid diagnosis of TB and anti-tuberculous drug resistance in clinical microbiology laboratories.
authors.affiliation: Servicio de Microbiología, IDIBELL-Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. falcaide@bellvitgehospital.cat
authors.forename: Fernando
authors.initials: F
authors.lastname: Alcaide
authors.forename: Pere
authors.initials: P
authors.lastname: Coll
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use; D001431:Bacteriological Techniques / Q000379:methods*; D001435:Bacteriophages / Q000302:isolation & purification; D003199:Computer Systems; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics; D004352:Drug Resistance, Microbial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D042241:Early Diagnosis; D008401:Gas Chromatography-Mass Spectrometry; D005838:Genotype; D006801:Humans; D055985:Latent Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D008826:Microbial Sensitivity Tests / Q000379:methods*; D025202:Molecular Diagnostic Techniques / Q000379:methods*; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification* / Q000821:virology; D013997:Time Factors; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents; D004269:DNA, Bacterial