Comparison of an in-house multiplex PCR with two commercial immuno-chromatographic tests for rapid identification and differentiation of MTB from NTM isolates

Background: Species specific diagnosis of mycobacterial infection is crucial because treatment of infections caused by Mycobacterium tuberculosis (MTB) differs from that of non-tuberculous mycobacterial (NTM) species. The species identification used to be cumbersome and non-reproducible a decade ago...

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Main Authors: Parveen Kumar, Prit Benny, Manisha Jain, Sarman Singh
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2014-01-01
Series:International Journal of Mycobacteriology
Subjects:
Online Access:http://www.ijmyco.org/article.asp?issn=2212-5531;year=2014;volume=3;issue=1;spage=50;epage=56;aulast=Kumar
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author Parveen Kumar
Prit Benny
Manisha Jain
Sarman Singh
author_facet Parveen Kumar
Prit Benny
Manisha Jain
Sarman Singh
author_sort Parveen Kumar
collection DOAJ
description Background: Species specific diagnosis of mycobacterial infection is crucial because treatment of infections caused by Mycobacterium tuberculosis (MTB) differs from that of non-tuberculous mycobacterial (NTM) species. The species identification used to be cumbersome and non-reproducible a decade ago. Objectives: Recently, some commercial tests have been made available to differentiate the MTB and NTM growths in culture media. Sensitivity and specificity of these tests was evaluated. Materials and methods: In this double blind study 572 clinical samples were cultured in an automated BACTEC-MGIT-960 system. A total of 147 (25.7%) samples were MGIT culture positive. These cultures were subjected to an in-house m-PCR (which amplifies hsp-65, esat-6 and ITS region for MAC), two commercial immune-chromatographic tests (ICTs) and phenotypic tests. Results: Of the 147 MGIT positive cultures, m-PCR was able to correctly identify MTB in 123 cultures and NTM in 24 which included 3 MAC isolates. m-PCR showed 100% agreement with two gold standard methods-the nitrate reductase assay and PNB tests-in correctly identifying MTB. Commercial strips were able to correctly identify MTB in 120 (97.5%) of 123 cultures, while 3 (2.5%) isolates were falsely identified as NTM. However, none of the growth negative spent medium gave false positive results in any of the tests. None of the commercial strips misidentified any of the 24 NTM as MTB; hence, specificity of these strips was 100%. Of the 2 IC test systems, both SD Bioline and BD TBc strip tests missed 2.5% of MTB isolates and misidentified these as NTM. Conclusion: The in-house m-PCR was found to be the most accurate and efficient tool for identifying the MTB, MAC and other NTMs.
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spelling doaj.art-15df0a1793ba47569b0767a3f33472462022-12-22T00:04:01ZengWolters Kluwer Medknow PublicationsInternational Journal of Mycobacteriology2212-55312212-554X2014-01-0131505610.1016/j.ijmyco.2013.12.001Comparison of an in-house multiplex PCR with two commercial immuno-chromatographic tests for rapid identification and differentiation of MTB from NTM isolatesParveen KumarPrit BennyManisha JainSarman SinghBackground: Species specific diagnosis of mycobacterial infection is crucial because treatment of infections caused by Mycobacterium tuberculosis (MTB) differs from that of non-tuberculous mycobacterial (NTM) species. The species identification used to be cumbersome and non-reproducible a decade ago. Objectives: Recently, some commercial tests have been made available to differentiate the MTB and NTM growths in culture media. Sensitivity and specificity of these tests was evaluated. Materials and methods: In this double blind study 572 clinical samples were cultured in an automated BACTEC-MGIT-960 system. A total of 147 (25.7%) samples were MGIT culture positive. These cultures were subjected to an in-house m-PCR (which amplifies hsp-65, esat-6 and ITS region for MAC), two commercial immune-chromatographic tests (ICTs) and phenotypic tests. Results: Of the 147 MGIT positive cultures, m-PCR was able to correctly identify MTB in 123 cultures and NTM in 24 which included 3 MAC isolates. m-PCR showed 100% agreement with two gold standard methods-the nitrate reductase assay and PNB tests-in correctly identifying MTB. Commercial strips were able to correctly identify MTB in 120 (97.5%) of 123 cultures, while 3 (2.5%) isolates were falsely identified as NTM. However, none of the growth negative spent medium gave false positive results in any of the tests. None of the commercial strips misidentified any of the 24 NTM as MTB; hence, specificity of these strips was 100%. Of the 2 IC test systems, both SD Bioline and BD TBc strip tests missed 2.5% of MTB isolates and misidentified these as NTM. Conclusion: The in-house m-PCR was found to be the most accurate and efficient tool for identifying the MTB, MAC and other NTMs.http://www.ijmyco.org/article.asp?issn=2212-5531;year=2014;volume=3;issue=1;spage=50;epage=56;aulast=KumarMultiplex-PCRBD stripSD bioline stripMTBNTMMAC
spellingShingle Parveen Kumar
Prit Benny
Manisha Jain
Sarman Singh
Comparison of an in-house multiplex PCR with two commercial immuno-chromatographic tests for rapid identification and differentiation of MTB from NTM isolates
International Journal of Mycobacteriology
Multiplex-PCR
BD strip
SD bioline strip
MTB
NTM
MAC
title Comparison of an in-house multiplex PCR with two commercial immuno-chromatographic tests for rapid identification and differentiation of MTB from NTM isolates
title_full Comparison of an in-house multiplex PCR with two commercial immuno-chromatographic tests for rapid identification and differentiation of MTB from NTM isolates
title_fullStr Comparison of an in-house multiplex PCR with two commercial immuno-chromatographic tests for rapid identification and differentiation of MTB from NTM isolates
title_full_unstemmed Comparison of an in-house multiplex PCR with two commercial immuno-chromatographic tests for rapid identification and differentiation of MTB from NTM isolates
title_short Comparison of an in-house multiplex PCR with two commercial immuno-chromatographic tests for rapid identification and differentiation of MTB from NTM isolates
title_sort comparison of an in house multiplex pcr with two commercial immuno chromatographic tests for rapid identification and differentiation of mtb from ntm isolates
topic Multiplex-PCR
BD strip
SD bioline strip
MTB
NTM
MAC
url http://www.ijmyco.org/article.asp?issn=2212-5531;year=2014;volume=3;issue=1;spage=50;epage=56;aulast=Kumar
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