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Mycobacteria

Some Mycobacteria cause various pulmonary or extrapulmonary diseases such as tuberculosis (TB), leprosy, and nontuberculous mycobacterial disease. According to the World Health Organization (WHO), TB killed 1.5 million people in 2018 - more than any other infectious disease. TB primarily affects the lungs, so in light of the recent coronavirus pandemic, efforts are being made to understand how TB patients might be affected by co-infection with SARS-CoV-2.

With research suggesting up to 6.3 million more people may develop TB between now and 2025 and 1.4 million more expected to die as cases go undiagnosed and untreated during lockdown,i it is critical that cases are diagnosed and treated correctly.

One of the challenges facing the fight against TB is that the pathogen can persist in many infected individuals in a latent (inactive) state for several years, reactivating later to cause disease. The risk of progression to TB disease after infection is highest soon after the initial infection and increases considerably for people co-infected with HIV/AIDS or other immunocompromising conditions.

The issue of drug resistance

Multidrug-resistant TB (MDR-TB) has been documented across the globe and is a significant barrier to the ongoing efforts to tackle TB. Patients with MDR-TB often require up to two years of chemotherapy with medicines that are expensive and toxic, making treatment difficult for patients. It can be assumed that such humans already weakened by other illnesses, such as COVID-19, will be hit even harder by severe side effects of a MDR drug regime.

In extensively drug-resistant TB (XDR-TB), a more serious form of MDR-TB caused by bacteria that do not respond to the most effective second-line anti-TB drugs, often leaving patients with only very limited further treatment options. Total drug-resistent TB (TDR-TB) is defined as out of any drug based treatment options.

Protecting vulnerable patients

Identifying high risk populations has never been more important. Of the estimated 10.4 million new cases of TB each year, around 3 million remain unknown to the health system, and are therefore not receiving appropriate treatment.ii Underdiagnosis can result from poor geographical and financial access to healthcare, failure to test for TB when people do visit health facilities, or lack of sensitive or specific diagnostic tests to provide an accurate identification.

Our nucleic acid based amplification (NAAT) molecular assays are providing labs with the tools to accurately identify the infecting organism, including nontuberculous mycobacteria (NTM). If it is suspected that a TB infection might be caused by resistant mycobacteria, some tests also provide beside identification of TB fast and reliable information of susceptibility to all main important first and second line antibiotics. Within the range of mycobacteria assays the FluoroType® MTBDR represents a highly innovative test based on the LiquidArray® technology.

As a provider of broad spectrum molecular diagnostic (MDx) tests we also offer direct testing of SARS-CoV-2 (FluoroType® SARS-CoV-2 plus) from various specimens.

REFERENCES

i Stop TB Partnership, May 2020: https://www.theguardian.com/global-development/2020/may/06/millions-develop-tuberculosis-tb-covid-19-lockdown

ii Bloom BR, Atun R, Cohen T, et al. Tuberculosis. In: Holmes KK, Bertozzi S, Bloom BR, et al., editors. Major Infectious Diseases. 3rd edition. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2017 Nov 3. Chapter 11. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525174/ doi: 10.1596/978-1-4648-0524-0/ch11

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