0
Editorials |

Dilemmas and Realities of Rapid Diagnostic Tests for Tuberculosis

Leonid Heifets, MD, PhD, ScD
Author and Funding Information

Affiliations: Denver, CO 
 ,  Dr. Heifets is Director, Mycobacteriology Laboratory, National Jewish Medical and Research Center, and Professor of Microbiology and Medicine, University of Colorado Health Sciences Center, Denver, CO.

Correspondence to: Leonid Heifets, MD, PhD, ScD, Director, Mycobacteriology Laboratory, National Jewish Medical and Research Center, 1400 Jackson St, Denver CO 80206-2761



Chest. 2000;118(1):4-5. doi:10.1378/chest.118.1.4
Text Size: A A A
Published online

Extract

Over a period of > 100 years, the only rapid test for presumptive diagnosis of tuberculosis (TB) was the smear examination of the patient’s specimen for acid-fast bacilli (AFB). Smear from a nonprocessed sputum specimen can be positive if the specimen contains > 100,000 AFB/mL, but the sensitivity of this method can be increased to detect 10,000 and even 1,000 AFB/mL, if the specimen is concentrated through appropriate processing and centrifugation, and the smear is examined by means of fluorescent microscopy. So far, culture isolation remains the final laboratory diagnosis of TB. Incorporation of the rapid broth-culture methods (for example, BACTEC-460 from Becton Dickinson [Diagnostic Instrument Systems; Sparks, MD]), used along with the solid media, into the laboratory protocols expedited recovery of growth of Mycobacterium tuberculosis from most of the smear-positive specimens within 2 weeks, and from most of the smear-negative specimens within 3 weeks. Additional application of the rapid identification techniques, such as the AccuProbe test (Gen-Probe; San Diego, CA) or high-pressure liquid chromatography (with a fluorescent detector), provides precise and final diagnosis within an additional 24 to 48 h with the cultures grown in liquid medium.

First Page Preview

View Large
First page PDF preview

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543