Release Date: Aug 2019
CC: PC, MK, PBL, SBP
Matthew J. Bankowski, PhD, MS, D(ABMM), HCLD/CC(ABB)
Clinical and Molecular Microbiology Laboratory Director, Baptist Medical Center, Jacksonville, FL; Courtesy Professor, University of Florida College of Medicine–Jacksonville Department of Pediatrics, Jacksonville, FL
After completing this course, participants will be able to:
- Describe the advances in clinical molecular infectious disease diagnostics for Mycobacterium tuberculosis (Mtb) and non-tuberculosis mycobacteria (NTM).
- Describe the clinical usefulness of PCR for the direct detection of M. tuberculosis and drug resistance in respiratory and non-respiratory specimens.
- Explain the significance of using a multiplex molecular assay for the detection of Mtb with NTM co-infection.
- Discuss MALDI-TOF-MS NTM detection and its usefulness in the identification and choice of empiric antimicrobial therapy.
Who should attend? Practicing Pathologists, Residents, Doctoral Scientists, Laboratory Managers, Bench Supervisors, Bench Technologists & Technicians
Approximately one-third of the world’s population is infected with M. tuberculosis. The AFB smear is the recognized standard for “presumptive support” of TB infection. However, a positive smear does not confirm the presence of M. tuberculosis, because culture recovery and identification are still required. It is also documented that less than 50% of newly diagnosed TB patients are detected using an AFB smear. These deficiencies in TB diagnostics have provided the impetus for introducing more novel approaches for the more timely detection of M. tuberculosis infection. Nucleic acid amplification testing (NAAT, such as Xpert MTB/RIF) has been successfully introduced and exhibits greater sensitivity for the direct and specific detection of Mtb and drug resistance, while maintaining the rapid test turnaround time needed for pulmonary specimens. Likewise, the benefit of improved test performance using NAAT for extra-pulmonary specimens is also being actively investigated. This course will focus on the advances in TB diagnostics using NAAT (e.g., Xpert MTB/RIF) for pulmonary and extra-pulmonary specimens, the use of MALDI-TOF-MS for NTM identification, and other novel approaches using Xpert MTB/RIF. The goal is to maximize the use of molecular diagnostics in an efficient cost-containment fashion in order to optimize patient care and improve clinical outcome.