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Molecular bacterial load assay versus culture for monitoring treatment response in adults with tuberculosis

The lack of rapid, sensitive, and deployable tuberculosis diagnostic tools is hampering the early diagnosis of tuberculosis and early detection of treatment failures. The conventional sputum smear microscopy or Xpert MTB/RIF assay cannot distinguish between alive and dead bacilli and the culture met...

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Autores principales: Said, Bibie, Charlie, Loveness, Getachew, Emnet, Wanjiru, Catherine Lydiah, Abebe, Mekdelawit, Manyazewal, Tsegahun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8287413/
https://www.ncbi.nlm.nih.gov/pubmed/34349999
http://dx.doi.org/10.1177/20503121211033470
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author Said, Bibie
Charlie, Loveness
Getachew, Emnet
Wanjiru, Catherine Lydiah
Abebe, Mekdelawit
Manyazewal, Tsegahun
author_facet Said, Bibie
Charlie, Loveness
Getachew, Emnet
Wanjiru, Catherine Lydiah
Abebe, Mekdelawit
Manyazewal, Tsegahun
author_sort Said, Bibie
collection PubMed
description The lack of rapid, sensitive, and deployable tuberculosis diagnostic tools is hampering the early diagnosis of tuberculosis and early detection of treatment failures. The conventional sputum smear microscopy or Xpert MTB/RIF assay cannot distinguish between alive and dead bacilli and the culture method delays providing results. Tuberculosis molecular bacterial load assay is a reverse transcriptase real-time quantitative polymerase chain reaction that quantifies viable tuberculosis bacillary load as a marker of treatment response for patients on anti-tuberculosis therapy. However, results are not synthesized enough to inform its comparative advantage to tuberculosis culture technique which is yet the gold standard of care. With this review, we searched electronic databases, including PubMed, Embase, and Web of Science, from March 2011 up to February 2021 for clinical trials or prospective cohort studies that compared tuberculosis molecular bacterial load assay with tuberculosis culture in adults. We included eight studies that meet the inclusion criteria. Tuberculosis molecular bacterial load assay surpasses culture in monitoring patients with tuberculosis during the first few weeks of anti-tuberculosis treatment. It is more desirable over culture for its shorter time to results, almost zero rates of contamination, need for less expertise on the method, early rate of decline, lower running cost, and reproducibility. Its rapid and specific tuberculosis treatment monitoring competency benefits patients and healthcare providers to monitor changes of bacillary load among isolates with drug-susceptible or resistance to anti-tuberculosis regimens. Despite of the high installing cost of the tuberculosis molecular bacterial load assay method, molecular expertise, and a well-equipped laboratory, tuberculosis molecular bacterial load assay is a cost-effective method with comparison to culture in operational running. To achieve maximum utility in high tuberculosis burden settings, an intensive initial investment in nucleic acid extraction and polymerase chain reaction equipment, training in procedures, and streamlining laboratory supply procurement systems are crucial. More evidence is needed to demonstrate the potential large-scale and sustainable use of tuberculosis molecular bacterial load assay over culture in resource-constrained settings.
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spelling pubmed-82874132021-08-03 Molecular bacterial load assay versus culture for monitoring treatment response in adults with tuberculosis Said, Bibie Charlie, Loveness Getachew, Emnet Wanjiru, Catherine Lydiah Abebe, Mekdelawit Manyazewal, Tsegahun SAGE Open Med Review The lack of rapid, sensitive, and deployable tuberculosis diagnostic tools is hampering the early diagnosis of tuberculosis and early detection of treatment failures. The conventional sputum smear microscopy or Xpert MTB/RIF assay cannot distinguish between alive and dead bacilli and the culture method delays providing results. Tuberculosis molecular bacterial load assay is a reverse transcriptase real-time quantitative polymerase chain reaction that quantifies viable tuberculosis bacillary load as a marker of treatment response for patients on anti-tuberculosis therapy. However, results are not synthesized enough to inform its comparative advantage to tuberculosis culture technique which is yet the gold standard of care. With this review, we searched electronic databases, including PubMed, Embase, and Web of Science, from March 2011 up to February 2021 for clinical trials or prospective cohort studies that compared tuberculosis molecular bacterial load assay with tuberculosis culture in adults. We included eight studies that meet the inclusion criteria. Tuberculosis molecular bacterial load assay surpasses culture in monitoring patients with tuberculosis during the first few weeks of anti-tuberculosis treatment. It is more desirable over culture for its shorter time to results, almost zero rates of contamination, need for less expertise on the method, early rate of decline, lower running cost, and reproducibility. Its rapid and specific tuberculosis treatment monitoring competency benefits patients and healthcare providers to monitor changes of bacillary load among isolates with drug-susceptible or resistance to anti-tuberculosis regimens. Despite of the high installing cost of the tuberculosis molecular bacterial load assay method, molecular expertise, and a well-equipped laboratory, tuberculosis molecular bacterial load assay is a cost-effective method with comparison to culture in operational running. To achieve maximum utility in high tuberculosis burden settings, an intensive initial investment in nucleic acid extraction and polymerase chain reaction equipment, training in procedures, and streamlining laboratory supply procurement systems are crucial. More evidence is needed to demonstrate the potential large-scale and sustainable use of tuberculosis molecular bacterial load assay over culture in resource-constrained settings. SAGE Publications 2021-07-17 /pmc/articles/PMC8287413/ /pubmed/34349999 http://dx.doi.org/10.1177/20503121211033470 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Said, Bibie
Charlie, Loveness
Getachew, Emnet
Wanjiru, Catherine Lydiah
Abebe, Mekdelawit
Manyazewal, Tsegahun
Molecular bacterial load assay versus culture for monitoring treatment response in adults with tuberculosis
title Molecular bacterial load assay versus culture for monitoring treatment response in adults with tuberculosis
title_full Molecular bacterial load assay versus culture for monitoring treatment response in adults with tuberculosis
title_fullStr Molecular bacterial load assay versus culture for monitoring treatment response in adults with tuberculosis
title_full_unstemmed Molecular bacterial load assay versus culture for monitoring treatment response in adults with tuberculosis
title_short Molecular bacterial load assay versus culture for monitoring treatment response in adults with tuberculosis
title_sort molecular bacterial load assay versus culture for monitoring treatment response in adults with tuberculosis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8287413/
https://www.ncbi.nlm.nih.gov/pubmed/34349999
http://dx.doi.org/10.1177/20503121211033470
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