Information about diagnostic methods and techniques for tuberculosis including microscopy, fluorescence microscopy, mycobacterial culture, molecular techniques (line probe assay, Xpert MTB/RIF), interferon gamma release assay (IGRA) and tuberculin skin test (TST)
This presentation is about lab diagnosis of tuberculosis. It highlights use of currently available diagnostic methods in identifying pulmonary and extrapulmonary tuberculosis.
This presentation is about lab diagnosis of tuberculosis. It highlights use of currently available diagnostic methods in identifying pulmonary and extrapulmonary tuberculosis.
what is new in prevention, diagnosis and treatment of tuberculosis tb short.pptxPathKind Labs
Many changes have been made recently in Tuberculosis. The first important change is that instead of control now the focus is on eradication. for that to happen we need to change the way we detect, diagnose and treat tuberculosis.
RECENT ADVANCES IN DIAGNOSIS OF TUBERCULOSISANGAN KARMAKAR
TRADITIONAL TESTS AND RECENT DIAGNOSTIC MODALITIES FOR TUBERCULOSIS WITH EMPHASIS TO MOLECULAR DETECTION TECHNIQUES, DRUG SENSITIVITY ASSESMENT IN INDIAN PERSPECTIVE
Newer diagnostic methods in tuberculosis detectionApollo Hospitals
One-third of the world's population has been infected with Mycobacterium tuberculosis, with new infections occurring in about 1% of the population each year. However 90–95% of infections remain asymptomatic. Thus early diagnosis of tuberculosis and drug resistance improves survival and helps to promote contact tracing, implementation of institutional cross-infection procedures, and other public-health actions. There have been many advances and modifications to the methodology for tuberculosis diagnosis some of which are very promising. But these advances have not kept pace with the explosion of tuberculosis or the outbreak of drug resistant tuberculosis. This review describes some of the newer advances in tuberculosis diagnostics and the challenges they face.
Tuberculosis is a raging problem round the globe. Eradicating TB is a herculean task but is possible is efforts from all corners from the world. The diagnostics have taken a big leap and with effective medications, our dream of TB free world may come true. But unlimited efforts are need to reach our goal.
he WHO Global Tuberculosis Report 2022 provides a comprehensive and up-to-date assessment of the TB epidemic and of progress in prevention, diagnosis and treatment of the disease, at global, regional and country levels.
what is new in prevention, diagnosis and treatment of tuberculosis tb short.pptxPathKind Labs
Many changes have been made recently in Tuberculosis. The first important change is that instead of control now the focus is on eradication. for that to happen we need to change the way we detect, diagnose and treat tuberculosis.
RECENT ADVANCES IN DIAGNOSIS OF TUBERCULOSISANGAN KARMAKAR
TRADITIONAL TESTS AND RECENT DIAGNOSTIC MODALITIES FOR TUBERCULOSIS WITH EMPHASIS TO MOLECULAR DETECTION TECHNIQUES, DRUG SENSITIVITY ASSESMENT IN INDIAN PERSPECTIVE
Newer diagnostic methods in tuberculosis detectionApollo Hospitals
One-third of the world's population has been infected with Mycobacterium tuberculosis, with new infections occurring in about 1% of the population each year. However 90–95% of infections remain asymptomatic. Thus early diagnosis of tuberculosis and drug resistance improves survival and helps to promote contact tracing, implementation of institutional cross-infection procedures, and other public-health actions. There have been many advances and modifications to the methodology for tuberculosis diagnosis some of which are very promising. But these advances have not kept pace with the explosion of tuberculosis or the outbreak of drug resistant tuberculosis. This review describes some of the newer advances in tuberculosis diagnostics and the challenges they face.
Tuberculosis is a raging problem round the globe. Eradicating TB is a herculean task but is possible is efforts from all corners from the world. The diagnostics have taken a big leap and with effective medications, our dream of TB free world may come true. But unlimited efforts are need to reach our goal.
he WHO Global Tuberculosis Report 2022 provides a comprehensive and up-to-date assessment of the TB epidemic and of progress in prevention, diagnosis and treatment of the disease, at global, regional and country levels.
Mvss part v weaning & liberation from mechanical ventilationSanti Silairatana
Slides accompanying the Lecture/Review Mechanical Ventilatory support series part V/V: Weaning and liberation from mechanical ventilatory support. For medical students and residents in Internal medicine. Contents are including rationale of weaning, predictors of weaning success and failure, methods of weaning, and detection and management of weaning failure
This is a presentation giving an overview of the GeneXpert DX system for detection of MTB. The assay described in this presentation is the MTB/RIF test.
Internal medicine review for national license examination 2 Santi Silairatana
Internal Medicine review, with focus on pulmonary medicine and critical care medicine including pneumonia, asthma, COPD, tuberculosis, and sepsis & septic shock. Intended to be used for medical students.
Information and Knowledge for medical professionals about electrocardiography including rationale, standardization, and interpretation. This is part one of
Tuberculosis- International Perspectives on Epidemiology, diagnosis and ControlsRanjini Manuel
Tuberculosis (TB) is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. Tuberculosis is curable and preventable.
TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.
About one-quarter of the world's population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit the disease.
People infected with TB bacteria have a 5–15% lifetime risk of falling ill with TB. Persons with compromised immune systems, such as people living with HIV, malnutrition or diabetes, or people who use tobacco, have a higher risk of falling ill.
GeneXpert MTB/RIF: A Useful Tool for Rapid and Accurate Diagnosis of Tubercul...komalicarol
The primary objective of this study was to show the usefulness and
importance of GeneXpert MTB/RIF, a rapid test that simultaneously detects Mycobacterium tuberculosis complex (MTBC) and
resistance to rifampicin (RIF) in less than 2 hours.
ICN Victoria presents Professor Oliver Cornely, Professor of Internal Medicine and Director for Clinical Trials at University Hospital, Cologne, Germany. His research interests include invasive fungal diseases in haematology/oncology and in the ICU setting. Dr Cornely is also a clinical infectious diseases consultant at the University Hospital of Cologne.
Professor Cornely gives an entertaining talk on the pervasiveness, invasiveness, diagnosis and treatment of fungal infections in ICU patients.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Tuberculosis diagnostics
1. ปลอด TB ชีวีมีสุข
แนวทางเพื่อการวินิจฉัยที่แม่นยำ รักษาได้ตรงจุด และได้ผลการรักษาที่ดี
S a n t i S i l a i r a t a n a , M D
Division of Pulmonary Medicine, Department of Medicine,
Facul ty of Medicine Vaj i ra Hospi tal
Navamindradhiraj Unive r s i ty
3. Tuberculosis
ESTIMATED
INCIDENCE
1,788,043
1,334,066
627,047
362,819
360,767
278,392
251,685
241,537
236,885
195,207
194,627
160,688
144,942
137,260
110,319
106,201
89,351
86,130
85,015
84,546
79,656
WHO. Global tuberculosis control: surveillance, planning, financing: WHO report 2005. Geneva: WHO, 2005.
2.
More people die from TB than from any
Poverty
Congregation
HIV pandemic
4. Tuberculosis-HIV Coinfection
resistant, it is estimated that over
countries) in active TB cases.
countries or the volume of testing.
Figure 5
PREVALENT ADULT TB CASES COINFECTED WITH HIV, 2004
Source: reference 3.
Dye C, Watt CJ, Bleed DM et al. Journal of American Medical Association 2005; 293:2767-75.
5. The Gap between Estimated and Notified Cases
Estimated TB cases
8.8 Million
4.1 Million cases
Recorded & reported
Health
facility
TB cases
Diagnostic
tests
reported
Detected but
not notified
private sector
military
prisons
⊕
⊖
WHO. Global tuberculosis control: surveillance, planning, financing: WHO report 2005. Geneva: WHO, 2005.
6. Multidrug-resistant and Extensively drug-resistant TB
Multidrug-resistant (MDR) TB
Resistance against at least
rifampicin and isoniazid
Extensively drug-resistant (XDR) TB
MDR-TB PLUS
Resistance to any fluoroquinolones
AND
≥1 injectable second-line agents
O’Grady J, Maeurer M, Mwaba P et al. Current Opinion in Pulmonary Medicine 2011, 17; 134-141.
(ethionamide, prothionamide, cycloserine, terizidone,
para-aminosalicylic acid, clofazimine, amoxicillin-clavula-nate,
are those used directly on patient samples where a set
of drug-containing and drug-free media is inoculated
136 Infectious diseases
Figure 2 Estimated percentage of multiple drug resistant tuberculosis among new tuberculosis cases, 2008a
, 0 to <3; , 3 to <6; , 6 to <12; , 12 to <18; , "18;‘, no data available; , subnational data only. Reproduced with
permission from [2].
13. Sputum Microscopy for Acid-fast Bacilli
Friedrich Carl Adolf Neelsen
(1854-1898)
Franz Ziehl
(1857-1926)
Neelsen-Ziehl (Acid fast bacilli) Staining
Acid-fast bacilli appear pink
in a contrasting methylene blue background
14. Diagnostic Threshold underly Light Microscopy
system
may
TB
appropri-ate
Threshold for visibility of AFB by smear microscopy
10,000
Number of TB bacilli per millilitre
(ml) of sputum
Cough worsens:
patient returns
to clinic
Blood appears
in sputum;
infant daughter
infected
with TB
Too weak
to work
AFB+:
TB diagnosis
made
Patient
visits clinic:
no diagnosis
made
First smear:
AFB negative
Patient
returns
to clinic
Patient visits
pharmacy
Night cough
begins
Infection of
healthy patient
Patient feels
unwell
first month second month third month fourth month fifth month
AFB = acid-fast bacilli = smear+
Figure 6
A TB PATIENT’S JOURNEY FROM SYMPTOMS TO DIAGNOSIS
WHO. Diagnostics for Tuberculosis: Global Demand and Market Potential. Geneva: WHO 2006.
15. Fluorescence Microscopy: Mercury Vapor Lamp
Use Mercury Vapor as a light source
Staining of specimens with Auramine-O
Higher sensitivity than light microscopy,
comparable specificity
Requires a dark room for examination
WHO. Fluorescent light-emitting diode (LED) microscopy for diagnosis of tuberculosis: policy statement. Geneva: WHO 2011.
16. Light Emitting Diode (LED) Fluorescence Microscopy
Same (or slightly more) sensitivity
Cheaper and longer life duration of bulb (10,000 hr)
Cheaper microscopy
A dark room is not required
WHO recommended to use LED fluorescence
microscope as a standard technique
WHO. Fluorescent light-emitting diode (LED) microscopy for diagnosis of tuberculosis: policy statement. Geneva: WHO 2011.
17. Methods Sensitivity and Specificity
Method Sensitivity (%) Specificity (%)
Light microscopy 32-94 94
Mercury vapor
fluorescence
microscopy
52-97 94
LED fluorescence
microscopy 58-97 95
Steingart KR, Ng V, Henry M, et al. Lancet Infect Dis. 2006
21. Gene Xpert MTB/RIF: Features
Integrated sample processing
and PCR in a disposable plastic cartridge
All automatic
Bacterial lysis
Nucleic acid extraction
Amlification
Amplicon detection
Boehme CC, Nabeta P, Hillermann D, et al. N Engl J Med 2010; 363:1005-1015.
23. Boehme CC, Nabeta P, Hillermann D, et al. N Engl J Med 2010; 363:1005-1015.
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Figure 2. Assay Procedure for the MTB/RIF Test.
Two volumes of sample treatment reagent are added to each volume of sputum. The mixture is shaken, incubated at room temperature
for 15 minutes, and shaken again. Next, a sample of 2 to 3 ml is transferred to the test cartridge, which is then loaded into the instru-ment.
All subsequent steps occur automatically. The user is provided with a printable test result, such as “MTB detected; RIF resistance
25. Gene Xpert MTB/RIF: Performance
98.2% 72.5%
Sensitivity 98%
Boehme CC, Nabeta P, Hillermann D, et al. N Engl J Med 2010; 363:1005-1015.
Smear-positive
specimens
Smear-negative
specimens
Sensitivity
compared with culture
99.2%
Specificity
Specificity 99%
MTB
detection
Rifampin
resistance
detection
26. Gene Xpert MTB/RIF: Pros and Cons
Easy preparation and processing
Almost all steps run automatically
Test results can be reported
within 2 hours
Can be used both for TB identification
and Rifampin susceptibility test
Adventages
Disadventages
High cost
High maintenance cost
Rifampin resistance detection only
27. Line Probe Assay (LPA)
Rapid molecular drug resistance detection
Reverse line blot hybridization
!
INNO-LiPA Rif.TB Test
Hain test: MDRTBplus, MDRTBsl
O’Grady J, Maeurer M, Mwaba P et al. Current Opinion in Pulmonary Medicine 2011, 17; 134-141.
28. Line Probe Assay (LPA): MDRTBplus and MDRTBsl
First-line drugs Second-line drugs
O’Grady J, Maeurer M, Mwaba P et al. Current Opinion in Pulmonary Medicine 2011, 17; 134-141.
29. Line Probe Assay (LPA)
≥97% ≥99%
Sensitivity Specificity
for detection of rifampin resistance
≥90% ≥99%
Sensitivity Specificity
for detection of
combined INH-RIF resistance
O’Grady J, Maeurer M, Mwaba P et al. Current Opinion in Pulmonary Medicine 2011, 17; 134-141.
30. LPA vs Conventional DST
Parsons LM, Somoskövi A, Gutierrez C et al. Clin Microbiol Rev. 24 (2). 2011; 314-350.
31. Line Probe Assay (LPA): Pros and Cons
Rapid processing and reporting (2-7 days)
Drug susceptibility testing to INH and RIF
(INNO-LiPA Rif.TB and MTBDRplus)
Drug susceptibility testing to second-line
agents (MTBDRsl)
NTM species identification
Adventages
Disadventages
Labour intensive
Requires highly trained personnel
Requires dedicated laboratory
space and equipment
Expensive (but cheaper than Xpert)
32. Indications for Rapid Drug Susceptibility Test
Risk factor(s) to carry drug resistant strains
Tuberculosis in the setting of close contact to MDR-TB
patient
Positive smear at 3 months after treatment
Positive smear at 5 months after treatment
Before changing regimen or adding any drugs to
the treatment regimen
Suspected NTM infection in smear positive patient
34. The Mantoux Tuberculin Skin Test
Injecting 0.1 mL of tuberculin purified protein
derivative (PPD) into the inner surface of the
forearm (intradermal injection)
Injection should be made with a tuberculin syringe
The needle bevel facing upward
The injection should produce a pale elevation of the
skin 6-10 mm in diameter
CDC. MMWR 2005; 54 (RR-17).
American Thoracic Society and CDC. Am J Respir Crit Care Med. 2000; 161.
35. Tuberculin Skin Test: Reading and Interpretation
An induration of ≥5 mm
!
HIV infected persons
A recent contact
Persons with fibrotic changes on chest radiograph consistent with prior TB
Patients with organ transplants
Immunosuppressed patients (e.g., 15 mg/day of prednisolone for ≥1 mo)
An induration of ≥10 mm
!
Recent immigrants (5 years) from high prevalence countries
Injection drug users
Residents and employees of high-risk congregate setting
Mycobacteriology laboratory personnel
Patient with clinical conditions that place them at high risk
Children 4 years of age
CDC. MMWR 2005; 54 (RR-17).
American Thoracic Society and CDC. Am J Respir Crit Care Med. 2000; 161.
POSITIVE
an induration
≥15 mm
48-72 hr after injection
36. Interferon-Gamma Release Assays (IGRAs)
QuantiFERON-TB Gold in-Tube T SPOT.TB
Measurement of a person’s immune
reactivity to M. tuberculosis
Do NOT help differentiate latent
tuberculosis (LTBI) from
tuberculosis disease
Routine testing with IGRA is NOT
recommended
Centers for Disease Control and Prevention. MMWR 2010; 59 (No.RR-5).
37. Characteristics of Commercially Available IGRAs
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination
(Page 1 of 3)
To conduct the tests, fresh blood samples are mixed
with antigens and controls. The antigens, testing
methods, and interpretation criteria for IGRAs differ
(see Table 1).
assay can decrease the accuracy of IGRAs.
t Limited data on the use of IGRAs to predict
who will progress to TB disease in the future.
Table1: Differences in Currently Available IGRAs
QFT–GIT T–Spot
Initial Process Process whole blood within 16 hours Process peripheral blood mononuclear
cells (PBMCs) within 8 hours, or if T-Cell
Xtend® is used, within 30 hours.
M. tuberculosis Antigen Single mixture of synthetic peptides
representing ESAT-6, CFP-10 and TB7.7
Separate mixtures of synthetic peptides
representing ESAT–6 and CFP-10
Measurement IFN-g concentration Number of IFN-g producing cells (spots)
Possible Results Positive, negative, indeterminate Positive, negative, indeterminate,
borderline
Centers for Disease Control and Prevention. MMWR 2010; 59 (No.RR-5).
38. Summary: Diagnosis of Tuberculosis
Clinical
Features
Microscopy
(AFB Stain)
Microbiology
(Culture)
Drug
susceptibility test
Imaging
Fluorescene
microscopy
Mercury vapor
LED
Liquid-based
culture
MGIT
Gene Xpert
MTB/RIF
Gene Xpert
MTB/RIF
Line probe
assays
INNO-LiPA Rif.TB
MDRTBplus
MDRTBsl
Immuno
reactivity test
Tuberculin
skin testing
!
QuantiFERON
T-spot.TB