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Chapter 4 : Laboratory Diagnosis and Susceptibility Testing for

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Abstract:

The modern clinical microbiology laboratories have a number of methods available that provide an accurate and rapid laboratory diagnosis of tuberculosis. Molecular methods are now part of the diagnostic algorithm in many laboratories and have dramatically shortened the time to diagnosis. An FDA-approved rapid-cycle PCR assay, for the first time, is being recommended not only for the direct detection of but also for the rapid detection of multidrug-resistant (i.e., MDR-TB) and, when one or two negative results are obtained, for removing patients from respiratory isolation ( ).

Citation: Procop G. 2017. Laboratory Diagnosis and Susceptibility Testing for , p 45-58. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0022-2016
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Figures

Image of Figure 1
Figure 1

The colonies of two different species are demonstrated on L-J agar slants. The isolate on the left is “rough and buff,” with colonies that have a cauliflower-like appearance. The isolate on the right, for comparison, is , a photochromogen that demonstrates pigment development after exposure to light.

Citation: Procop G. 2017. Laboratory Diagnosis and Susceptibility Testing for , p 45-58. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0022-2016
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Image of Figure 2
Figure 2

The MGIT 960 tube on the right contains growing mycobacteria and is fluorescent when exposed to UV light. In contrast, the tube on the left contains no mycobacteria.

Citation: Procop G. 2017. Laboratory Diagnosis and Susceptibility Testing for , p 45-58. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0022-2016
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Image of Figure 3
Figure 3

The aggregation of acid-fast bacilli into the suprastructure demonstrated here is termed cording and is highly suggestive of complex. The culture from which this was derived contained complex. The image is of a Ziehl-Neelsen stain at a magnification of ×500.

Citation: Procop G. 2017. Laboratory Diagnosis and Susceptibility Testing for , p 45-58. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0022-2016
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Image of Figure 4
Figure 4

These postamplification melting curves, derived using fluorescence resonance energy transfer probes following broad-range mycobacterial PCR, demonstrate that complex (MTB) can be differentiated from the nontuberculous mycobacteria (MK), (MA), and (MI).

Citation: Procop G. 2017. Laboratory Diagnosis and Susceptibility Testing for , p 45-58. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0022-2016
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Image of Figure 5
Figure 5

This pyrogram, derived from pyrosequencing of the hypervariable A region of the 16S rRNA gene following a broad-range mycobacterial PCR, may be used for mycobacterial identification.

Citation: Procop G. 2017. Laboratory Diagnosis and Susceptibility Testing for , p 45-58. In Schlossberg D (ed), Tuberculosis and Nontuberculous Mycobacterial Infections, Seventh Edition. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.TNMI7-0022-2016
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References

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