Diagnosis of Pulmonary Tuberculosis in HIV-Positive Patients by Microscopic Observation Drug Susceptibility Assay

The microscopic observation drug susceptibility assay (MODS) is a novel and promising test for the early diagnosis of tuberculosis (TB). We evaluated the MODS assay for the early diagnosis of TB in HIV-positive patients presenting to Pham Ngoc Thach Hospital for Tuberculosis and Lung Diseases in sou...

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Bibliographic Details
Published in:	Journal of Clinical Microbiology Vol. 48; no. 12; pp. 4573 - 4579
Main Authors:	Ha, Dang Thi Minh, Lan, Nguyen Thi Ngoc, Kiet, Vo Sy, Wolbers, Marcel, Hang, Hoang Thi Thanh, Day, Jeremy, Hien, Nguyen Quang, Tien, Nguyen Anh, An, Pham Thuy, Anh, Truong Thi, Oanh, Do Thi Tuong, Hoa, Chau Luong, Chau, Nguyen Thi Minh, Hai, Nguyen Ngoc, Binh, Ngo Thanh, Ngoc, Le Hong, Phuong, Doan Thanh, Quyet, Tran Van, Tuyen, Nguyen Thi Bich, Ha, Vo Thi, Nho, Nguyen Thi, Hoa, Dai Viet, Anh, Phan Thi Hoang, Dung, Nguyen Huy, Farrar, Jeremy, Caws, Maxine
Format:	Journal Article
Language:	English
Published:	Washington, DC American Society for Microbiology 01-12-2010 American Society for Microbiology (ASM)
Subjects:	Adult Antitubercular Agents - pharmacology Bacterial diseases Bacterial diseases of the respiratory system Biological and medical sciences Early Diagnosis Female Fundamental and applied biological sciences. Psychology HIV Infections - complications Human bacterial diseases Human immunodeficiency virus Human viral diseases Humans Infectious diseases Male Medical sciences Microbial Sensitivity Tests - methods Microbiology Microscopy - methods Mycobacteriology and Aerobic Actinomycetes Mycobacterium Mycobacterium - drug effects Mycobacterium - growth & development Mycobacterium - isolation & purification Sensitivity and Specificity Sputum - microbiology Tuberculosis, Pulmonary - diagnosis Vietnam Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Vietnam Infection Immunopathology Lung disease Sensitivity Respiratory disease Viral disease Pulmonary tuberculosis Bacteriosis AIDS Mycobacterial infection Diagnosis Immune deficiency
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Summary:	The microscopic observation drug susceptibility assay (MODS) is a novel and promising test for the early diagnosis of tuberculosis (TB). We evaluated the MODS assay for the early diagnosis of TB in HIV-positive patients presenting to Pham Ngoc Thach Hospital for Tuberculosis and Lung Diseases in southern Vietnam. A total of 738 consecutive sputum samples collected from 307 HIV-positive individuals suspected of TB were tested by smear, MODS, and the mycobacteria growth indicator tube method (MGIT). The diagnostic sensitivity and specificity of MODS compared to the microbiological gold standard (either smear or MGIT) were 87 and 93%, respectively. The sensitivities of smear, MODS, and MGIT were 57, 71, and 75%, respectively, against clinical gold standard (MODS versus smear, P < 0.001; MODS versus MGIT, P = 0.03). The clinical gold standard was defined as patients who had a clinical examination and treatment consistent with TB, with or without microbiological confirmation. For the diagnosis of smear-negative patients, the sensitivities of MODS and MGIT were 38 and 45%, respectively (P = 0.08). The median times to detection using MODS and MGIT were 8 and 11 days, respectively, and they were 11 and 17 days, respectively, for smear-negative samples. The original bacterial/fungal contamination rate of MODS was 1.1%, while it was 2.6% for MGIT. The cross-contamination rate of MODS was 4.7%. In conclusion, MODS is a sensitive, specific, and rapid test that is appropriate for the detection of HIV-associated TB; its cost and ease of use make it particularly useful in resource-limited settings.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3
ISSN:	0095-1137 1098-660X
DOI:	10.1128/JCM.00687-10