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Faster, more accurate tuberculosis test developed

Researchers from the Johns Hopkins Bloomberg School of Public Health, the Imperial College London, Universidad Peruana Cayetano Heredia, in Lima, Peru, and other institutions have developed a simple and rapid new tuberculosis (TB) test. The test, called microscopic-observation drug-susceptibility or MODS, is more sensitive, faster and cheaper to perform than current culture-based tests. The study is published in the October 12, 2006, issue of the New England Journal of Medicine.

"In the fight to stop the spread of TB, new diagnostic tools are urgently needed to detect TB and multidrug-resistant TB. MODS is just such a tool. It will change the practice of TB testing in developing countries," said Robert H. Gilman, MD, senior author of the study and a professor in the Bloomberg School of Public Health's Department of International Health.

From April 2003 to July 2004, the study authors collected 3,760 sputum--saliva mixed with respiratory discharge--in order to complete sensitivity and susceptibility studies of the MODS test. All samples were decontaminated and then used for parallel MODS testing, as well as for two current gold standard TB tests-- the Lowenstein-Jensen culture and automated mycobacterial culture (using the MBBacT system). In order to test the samples using MODS, the researchers observed the cultures under an inverted light microscope for 40 days. The sensitivity of detecting TB was 97.8 percent for MODS culture, 89 percent for automated mycobacterial culture and 84 percent for Lowenstein-Jensen culture, when compared to each other. The median time for detection of TB was 7 days for MODS culture, 13 days for automated mycobacterial culture and 26 days for Lowenstein-Jensen culture.

The researchers also introduced isoniazid, rifampin, ethambutol and streptomycin--TB antibiotics--to the cultures in order to detect drug-resistant TB. Compared to standard culture reference methods, drug-resistant susceptibility agreement for MODS
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Source:Johns Hopkins University Bloomberg School of Public Health


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