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Chapter 4 : Clinical Mycobacteriology (Tuberculosis) Laboratory: Services and Methods

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Abstract:

This chapter presents a broad picture of activities in a diagnostic mycobacteriology laboratory with a focus on detection, identification, and drug susceptibility testing. Development of rapid methods for mycobacterial species identification and drug susceptibility testing became especially important because of the extremely rapid progression of tuberculosis in human immunodeficiency virus (HIV)-positive individuals and because of the growing rates of drug resistance. In the modern worldwide systems of information networks and effective transportation systems, laboratory service does not have to be in close proximity to the patient or physician. Quality assurance (QA) is a system targeting continuous improvement of quality of laboratory services. Three chromatographic methods have been proposed for the determination of mycobacterial species on the basis of their cell wall lipids: gas-liquid chromatography, high-pressure liquid chromatography (HPLC), and thin-layer chromatography. Of these approaches, HPLC is now the most popular in clinical mycobacteriology. The major problem was that HPLC, which is based on UV spectrophotometry to separate the ester peaks, required a large harvest of bacteria. Examples of some phenotypic methods which require bacterial growth but allow detection more rapidly by means other than conventional growth inhibition are described in the chapter. The future of tuberculosis laboratories and their ability to play a significant role in National Tuberculosis Programs in countries with a high burden of tuberculosis will depend on their ability to detect drug-resistant bacteria in a timely manner while taking financial constraints into account.

Citation: Heifets L, Desmond E. 2005. Clinical Mycobacteriology (Tuberculosis) Laboratory: Services and Methods, p 49-68. In Cole S, Eisenach K, McMurray D, Jacobs, Jr. W (ed), Tuberculosis and the Tubercle Bacillus. ASM Press, Washington, DC. doi: 10.1128/9781555817657.ch4
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Tables

Generic image for table
Table 1

Differentiation among the members of the complex

Citation: Heifets L, Desmond E. 2005. Clinical Mycobacteriology (Tuberculosis) Laboratory: Services and Methods, p 49-68. In Cole S, Eisenach K, McMurray D, Jacobs, Jr. W (ed), Tuberculosis and the Tubercle Bacillus. ASM Press, Washington, DC. doi: 10.1128/9781555817657.ch4
Generic image for table
Table 2

Critical concentrations for in different media

Citation: Heifets L, Desmond E. 2005. Clinical Mycobacteriology (Tuberculosis) Laboratory: Services and Methods, p 49-68. In Cole S, Eisenach K, McMurray D, Jacobs, Jr. W (ed), Tuberculosis and the Tubercle Bacillus. ASM Press, Washington, DC. doi: 10.1128/9781555817657.ch4

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