Bacteriophage Based Assay to Detect Mycobacteria in the Sputum of Tuberculosis Patients
Early, efficient, and inexpensive methods for the detection of pulmonary tuberculosis (TB) are urgently needed for effective patient management as well as to interrupt transmission. The major factors influencing the clinical outcome and control of the transmission of TB from patients includes the low sensitivity of the conventional Ziehl-Neelsen method and the long time taken to obtain drug susceptibility data. One of the most promising approaches is the use of mycobacteriophage D29 to demonstrate the viable mycobacterium cells. The aim of this review was to document the role of mycobacteriophages, particularly mycobacteriophage D29 to detect M. tuberculosis in sputum samples from TB patients. The review was organized by collecting different published information and after core laboratory skills were acquired. Fast PlaqueTM is a rapid test which utilizes bacteriophage amplification technology for the detection of viable M. tuberculosis in clinical specimens. Taking BACTEC 460 TB culture as the gold standard, the sensitivity of Fast PlaqueTM test reported 87.5% that Ziehl-Neelsen microscopy can detect when the sample has > 104 bacilli/ml of sputum, but the Fast PlaqueTM test can detect 100-300 bacilli/ml of sputum. The diagnostic performance of the Fast PlaqueTM test is reported to be comparable with the GeneXepert test, especially on smear negative specimens (sensitivity of 65% versus 72.5%, respectively). Moreover, the cost is by far less than that of the other available tests, like culture or polymerase chain reaction (PCR). In conclusion, the Fast PlaqueTM test has a good potential for rapid diagnosis of M. tuberculosis. Thus it can be useful in the diagnosis of tuberculosis as an adjunct to sputum microscopy particularly in TB endemic and resource poor countries. In addition, Fast PlaqueTM-RIFTM offered a performance comparable to the gold standard proportion methods of rifampicin susceptibility testing.
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