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Título:
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Clinical evaluation of tuberculosis viability microscopy for assessing treatment response
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Autores:
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Datta, Sumona ;
Sherman, Jonathan M. ;
Bravard, Marjory A. ;
Valencia, Teresa ;
Gilman, Robert H. ;
Evans, Carlton A.
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Tipo de documento:
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texto impreso
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Editorial:
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Oxford University Press, 2019-02-06T14:52:17Z
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Nota general:
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info:eu-repo/semantics/restrictedAccess
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
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Idiomas:
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Inglés
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Palabras clave:
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Editados por otras instituciones
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Artículos
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Artículos en revistas indizadas
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Resumen:
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BACKGROUND: It is difficult to determine whether early tuberculosis treatment is effective in reducing the infectiousness of patients' sputum, because culture takes weeks and conventional acid-fast sputum microscopy and molecular tests cannot differentiate live from dead tuberculosis. METHODS: To assess treatment response, sputum samples (n=124) from unselected patients (n=35) with sputum microscopy-positive tuberculosis were tested pretreatment and after 3, 6, and 9 days of empiric first-line therapy. Tuberculosis quantitative viability microscopy with fluorescein diacetate, quantitative culture, and acid-fast auramine microscopy were all performed in triplicate. RESULTS: Tuberculosis quantitative viability microscopy predicted quantitative culture results such that 76% of results agreed within +/-1 logarithm (rS=0.85; P<.0001 in patients with non-multidrug-resistant tuberculosis viability and quantitative culture results approximately halved log reduction p daily. for non-mdr available data by treatment day there was a>10-fold reduction in viability in 100% (24/24) of cases and quantitative culture in 95% (19/20) of cases. Four other patients subsequently found to have MDR tuberculosis had no significant changes in viability (P=.4) or quantitative culture (P=.6) results during early treatment. The change in viability and quantitative culture results during early treatment differed significantly between patients with non-MDR tuberculosis and those with MDR tuberculosis (both P<.001 acid-fast microscopy results changed little during early treatment and this change was similar for non-mdr tuberculosis vs mdr conclusions: quantitative viability is a simple test that within hour predicted culture became available weeks later rapidly indicating whether patients were responding to therapy.>
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En línea:
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http://doi.org/10.1093/cid/ciu1153
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