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• W2092502010 abstract "353 Currently, many difficulties are encountered in the identification of mycobacteria from clinical samples.1–3 Although sputa are still the main sample sources, the number of mycobacterial infections identified in nodes, pleura and osteoarticular sites are increasing.4 Besides Mycobacterium tuberculosis complex (MTBC), due to some M. bovis BCG vaccination problems, further differentiation of M. tuberculosis (MTB) from MTBC is also essential on some occasions.5,6 Furthermore, the isolation rate of nontuberculous mycobacteria (NTM) has been increasing, ranging from 30% to 50% of mycobacterial isolates reported from many hospital mycobacteriology laboratories in recent years.6–8 This is not due to sample contamination but, rather, has been ascribed to the use of sensitive broth culture systems such as MGIT (Mycobacteria Growth Indicator Tube; BD, USA) for mycobacteria detection.9 Although the clinical significance of many NTM remains to be evaluated, emerging infections cannot be ruled out and diagnostic systems need to be improved.7 Traditional X-ray radiography, acid fast bacilli (AFB) staining and culture methods will, gradually, not be able to cope with clinical requirements. The efficacy of current nucleic acid hybridization-based detection systems (including chips, arrays or liquid detection systems) is still not satisfactory as only a limited number of mycobacteria can be identified.10,11 Instead, emerging rapid and large-scale nucleic acid sequencing technology such as pyrosequencing might increasingly play important roles in application.12,13 Furthermore, samples other than sputa are characterized by few mycobacterial cells and the existence of complex PCR inhibitors.14–16 Thus, methods for increasing the efficiency of nucleic acid purification and increasing the detection limits must be improved.10 Another problem encountered is HIV infection and the problems of multi-drug resistant (MDR)/ extended drug-resistant (XDR) MTB.17–19 Although the current MDR/XDR drug resistance ratio is not very high (<10%), the situation must be monitored carefully. More rapid and accurate drug resistance detection methods such as direct DNA amplification and sequencing, electrophoresis and hybridization have to be developed and applied, in addition to the traditional antibiotic dilution methods.20 Furthermore, how the detection of latent infections from the community population can be improved is another important issue.21 While traditional antibody-antigen serodiagnosis assay by ELISA or related approaches are not practically applicable, in vitro QuantiFERON-TB and T SPOT TB assays22 based on the production of interferon-γ by T lymphocytes seem to be a promising method for the detection of latent infections.23–25 However, in future, in vivo testing of latent infection by ESAT-6 and CFP-10 to replace tuberculosis/PPD skin test (TST) assay might be Current Dilemma and Developments in the Diagnosis of Mycobacterium tuberculosis Infection Chia-Chen Lu,1 Hsin-Chih Lai2*" @default.
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• W2092502010 title "Current Dilemma and Developments in the Diagnosis of Mycobacterium tuberculosis Infection" @default.
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• W2092502010 doi "https://doi.org/10.1016/s0929-6646(08)60099-6" @default.
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