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The diagnostic usefulness of a DNA probe forMycobacterium tuberculosis complex (Gen-Probe®) in Bactec cultures versus other diagnostic methods

Diagnostischer Wert einer DNA Probe für Mycobacterium tuberculosis Complex (Gen-Probe®) in Bactec Kulturen im Vergleich zu anderen diagnostischen Methoden

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Summary

The combination of the radiometric Bactec system and the Gen-Probe® forMycobacterium tuberculosis complex (MTB) in detection and identification of mycobacteria was evaluated. Löwenstein-Jensen and Coletsos media for isolation, and Bactec-NAP® test and cellular morphology and grouping for identification of MTB and mycobacteria other than tuberculosis (MOTT) were also evaluated. The study included all specimens submitted to our laboratory for mycobacteria detection over a 6-month-period. The mean recovery times of MTB were 13.7, 23.3, and 21.2 days for Bactec, Löwenstein-Jensen and Coletsos, respectively. Bactec system recovered 87.8% of MTB strains and 98% of MOTT, and the conventional media 82.9% of MTB and 19.2% of MOTT. Ziehl-Neelsen smears and Bactec-NAP® were effective in differentiating MTB and MOTT strains (3.3% and 9.6% respectively of the cultures were uninterpretable). Gen-Probe® (cutoff point for MTB = 5% of hybridisation) was applied to 100 positive vials of Bactec. All cultures of MTB with a growth index (GI) > 400 displayed hybridisation > 9% (average 28.9%) but for a GI<400, 17% of cultures showed < 5% of hybridisation (average 18.6%). All cultures for MOTT had < 5% hybridisation. With the combination Bactec/Gen-Probe the average time of the final report could be reduced to 15.5 days.

Zusammenfassung

Die Kombination aus radiometrischem Bactec System und Gen-Probe® fürMycobacterium tuberculosis-Komplex (MTB) wurde hinsichtlich ihrer Leistungsfähigkeit für den Nachweis und die Identifizierung von Mykobakterien geprüft. Parallel wurden Löwenstein-Jensen- und Coletsos-Medien für die Isolation und Bactec-NAP® Test, Zellmorphologie und Lagerung für die Identifizierung von MTB und anderen Mykobakterien (MOTT) beurteilt. In die Studie wurden alle Proben einbezogen, die im Zeitraum von sechs Monaten für den Nachweis von Mykobakterien in unser Labor eingesandt wurden. Für den Nachweis von MTB benötigte Bactec 13,7, Löwenstein-Jensen 23,3 und Coletsos Medium 21,2 Tage. Mit dem Bactec System wurden 87,8% der MTB-Stämme und 98% der MOTT-Stämme identifiziert, mit den konventionellen Medien 82,9% der MTB und 19,2% der MOTT-Stämme. Ziehl-Neelsen-Präparate und Bactec NAP® waren effektiv in der Differenzierung von MTB und MOTT (3,3% beziehungsweise 9,6% der Kulturen konnten nicht beurteilt werden). Gen-Probe® (Grenzwert für MTB = 5% Hybridisierung) wurde bei 100 mit Bactec positiven Proben eingesetzt. Bei allen Kulturen von MTB mit einem Wachstumsindex von mehr als 400 fand sich eine Hybridisierung von mehr als 9% (im Durchschnitt 28,9%). Bei einem Wachstumsindex von weniger als 400 wiesen 17% der Kulturen weniger als 5% Hybridisierung auf (Durchschnitt 18,6%). Alle Kulturen, die MOTT enthielten, hatten eine Hybridisierung von weniger als 5% gezeigt. Mit der Kombination Bactec/Gen-Probe konnte die mittlere Zeit bis zum Abschlußbericht auf 15,5 Tage reduziert werden.

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Authors and Affiliations

  1. Servicio de Enfermedades Infecciosas y Microbiología Clínica, Spain

    M. Telenti Ph. D., M. Alvarez M. D. & M. J. Santos Rionda M. D.

  2. Servicio de Medicina, Departamento de Medicina, Spain

    J. F. B. de Quirós Ph. D.

  3. Departamento de Biología Funcional, Hospital General de Asturias, Facultad de Medicina, Universidad de Oviedo, c/ Julián Clavería s/n, E-33006, Oviedo, Spain

    M. C. Mendoza Ph. D.

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  1. M. Telenti Ph. D.
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  2. M. Alvarez M. D.
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  3. M. J. Santos Rionda M. D.
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Telenti, M., Alvarez, M., Santos Rionda, M.J. et al. The diagnostic usefulness of a DNA probe forMycobacterium tuberculosis complex (Gen-Probe®) in Bactec cultures versus other diagnostic methods. Infection 22, 18–23 (1994). https://doi.org/10.1007/BF01780758

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