RT Journal Article
SR Electronic
T1 Improving diagnosis and monitoring of treatment response in pulmonary tuberculosis using the molecular bacterial load assay (MBLA)
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 555995
DO 10.1101/555995
A1 Wilber Sabiiti
A1 Khalide Azam
A1 Davis Kuchaka
A1 Bariki Mtafya
A1 Ruth Bowness
A1 Katarina Oravcova
A1 Eoghan C W Farmer
A1 Isobella Honeyborne
A1 Dimitrios Evangelopoulos
A1 Timothy D McHugh
A1 Han Xiao
A1 Celso Khosa
A1 Andrea Rachow
A1 Norbert Heinrich
A1 Elizabeth Kampira
A1 Gerry Davies
A1 Nilesh Bhatt
A1 Nyanda Elias Ntinginya
A1 Sofia Viegas
A1 Ilesh Jani
A1 Mercy Kamdolozi
A1 Aaron Mdolo
A1 Margaret Khonga
A1 Martin J Boeree
A1 Patrick PJ Philips
A1 Derek J Sloan
A1 Michael Hoelscher
A1 Gibson Sammy Kibiki
A1 Stephen H Gillespie
YR 2019
UL http://biorxiv.org/content/early/2019/02/28/555995.abstract
AB Objectives Better outcomes in tuberculosis require new diagnostic and treatment monitoring tools. In this paper we evaluated the utility of a marker of M. tuberculosis viable count, the Molecular Bacterial Load assay (MBLA) for diagnosis and treatment monitoring of tuberculosis in a high burden setting.Methods Patients with smear positive pulmonary tuberculosis from two sites in Tanzania and one each in Malawi and Mozambique. Sputum samples were taken weekly for the first 12 weeks of treatment and evaluated by MBLA and mycobacterial growth indicator tube method (MGIT).Results The results of high and low positive control samples confirmed inter site reproducibility. Over the 12 weeks of treatment there was a steady decline in the viable bacterial load as measured by the MBLA that corresponds to rise in time to a positive result (TTP) in the Mycobacterial Growth Indicator Tube. Both MBLA and MGIT provided similar time to test negativity. Importantly, as treatment progressed samples in MGIT were increasingly likely to be contaminated, which compromised the acquisition of results but did not affect MBLA samples.Conclusions MBLA produces a reproducible measure of Mtb viable count comparable to that of MGIT that is not compromised by contamination in a real-world setting. As a molecular test, the results can be available in as little as four hours and could allow health care professionals to identify rapidly patients who are failing therapy.