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Clinical evaluation of tuberculosis viability microscopy for assessing treatment response

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dc.contributor.author Datta, Sumona
dc.contributor.author Sherman, Jonathan M.
dc.contributor.author Bravard, Marjory A.
dc.contributor.author Valencia, Teresa
dc.contributor.author Gilman, Robert Hugh
dc.contributor.author Evans, Carlton Anthony William
dc.date.accessioned 2019-02-06T14:52:17Z
dc.date.available 2019-02-06T14:52:17Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5292
dc.description.abstract 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 31 patients with non-multidrug-resistant (MDR) tuberculosis, viability and quantitative culture results approximately halved (both 0.27 log reduction, P<.001) daily. For patients with non-MDR tuberculosis and available data, by treatment day 9 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 tuberculosis (P=.6). CONCLUSIONS: Tuberculosis quantitative viability microscopy is a simple test that within 1 hour predicted quantitative culture results that became available weeks later, rapidly indicating whether patients were responding to tuberculosis therapy. en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartofseries Clinical Infectious Diseases
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Adult en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Male en_US
dc.subject Young Adult en_US
dc.subject Time Factors en_US
dc.subject fluorescein diacetate en_US
dc.subject early bactericidal activity en_US
dc.subject multidrug-resistant tuberculosis en_US
dc.subject Sputum/microbiology en_US
dc.subject Antitubercular Agents/therapeutic use en_US
dc.subject Bacteriological Techniques/methods en_US
dc.subject Microscopy/methods en_US
dc.subject Drug Monitoring/methods en_US
dc.subject Microbial Viability/drug effects en_US
dc.subject Tuberculosis/drug therapy en_US
dc.subject viability stain en_US
dc.subject vital stain tuberculosis en_US
dc.title Clinical evaluation of tuberculosis viability microscopy for assessing treatment response en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1093/cid/ciu1153
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 1537-6591


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