Rapid culture-based methods for drug-resistance detection in Mycobacterium tuberculosis.

Tuberculosis still represents a major public health problem, especially in low-resource countries where the burden of the disease is more important. Multidrug-resistant and extensively drug drug-resistant tuberculosis constitute serious problems for the efficient control of the disease stressing the need to investigate resistance to first- and second-line drugs. Conventional methods for detecting drug-resistance in Mycobacterium tuberculosis are slow and cumbersome. The most commonly used proportion method on Löwenstein-Jensen medium or Middlebrook agar requires a minimum of 3-4 weeks to produce results. Several new approaches have been proposed in the last years for the rapid and timely detection of drug-resistance in tuberculosis. This review will address phenotypic culture-based methods for rapid drug susceptibility testing in M. tuberculosis

Comparison of the ESP and BACTEC Systems for Testing Susceptibilities of Mycobacterium tuberculosis Complex Isolates to Pyrazinamide

Fifty isolates of Mycobacterium tuberculosis complex were tested for susceptibility to pyrazinamide (PZA) by the ESP (Trek Diagnostic Systems, Westlake, Ohio) and BACTEC (BD Biosciences, Sparks, Md.) test systems. Initial results showed concordance for 48 of the isolates. On retest, the two discordant isolates were resolved in favor of the ESP system. The ESP Myco susceptibility test system generates rapid, reliable PZA test results

Use of nucleic acid probes to identify mycobacteria directly from Difco ESP-Myco bottles.

Mycobacterial isolates were identified directly from positive ESP-Myco bottles by use of nucleic acid probes. Retrospective analysis of 360 cultures which grew either Mycobacterium tuberculosis, M. avium complex, or M. gordonae showed that 87% were identified by direct testing of an aliquot obtained at the time a positive culture was detected. Another 12% of these cultures gave results in the equivocal range, with only 1% of the isolates yielding negative results on initial testing

Mycobacterium thermoresistibile Infection following Knee-Replacement Surgery

We report a case of Mycobacterium thermoresistibile as a cause of infection following total knee replacement. This infection was masked by the prior isolation of a vancomycin-resistant enterococcus. The infection was resolved with long-term therapy using moxifloxacin and doxycycline

Mycobacterium thermoresistibile infection following knee-replacement surgery.

We report a case of Mycobacterium thermoresistibile as a cause of infection following total knee replacement. This infection was masked by the prior isolation of a vancomycin-resistant enterococcus. The infection was resolved with long-term therapy using moxifloxacin and doxycycline