New Diagnostic Methods for Tuberculosis / 대한내과학회지

ABSTRACT

Tuberculosis (TB) is one of the most important public issues for its global burden of mortality and morbidity. Rapid diagnosis and treatment of active TB are crucial in effective TB control because of lacking truly effective preventive strategy. In recent decades, drug-resistant TB (DR-TB) has emerged as an expanding threat, prompt and reliable laboratory detection of of DR-TB are urgently needed to limit the spread of them. Recently, nonmolecular and molecular assays has been developed for early detection of active TB with or without detection of drug resistance. Broth-based culture systems are capable of producing positive results in 3 weeks or less and many automated system can be widely used for drug susceptibility test. Nucleic acid amplication (NAA) assays have high specificity and positive predictive value, high sensitivity in smear positive specimens. Line probe assays shows high sensitivity for detecting resistance to rifampin and variables sensitivity for detecting resistance to isoniazid. XpertMTB/RIF assay, an automated rapid PCR device, showed high sensitivity and specificity for TB and rifampin resistance. Although new diagnostic methods can decrease turn-around time with considerable diagnostic accuracy and convenience, they are not a replacement for culture and conventional drug susceptibility test for diagnostic limitation in special situations.