The genus Mycobacterium can be divided into three groups for the purpose of diagnosis and treatment: Mycobacterium tuberculosis complex (MTC), the causative pathogens of tuberculosis (TB); non-tuberculous mycobacteria (NTM), with varying pathogenic potential; and Mycobacterium leprae, the causative pathogen of leprosy.
Infections by MTC and NTM mycobacteria continue to threaten several million people worldwide while challenging physicians and microbiologists to diagnose and control the spread. Exact species identification requires sophisticated techniques such as molecular diagnostics or mass spectrometry.
The infections resulting from MTC are even more difficult to treat due to intrinsic resistance to antibiotics like penicillin G, sulfonamides, tetracycline, erythromycin, and chloramphenicol.* Unfortunately, the number of non-tuberculous mycobacterial lung diseases (NTM) has steadily increased worldwide and with it the number of resistances in NTM. Identifying the drug resistance pattern is therefore crucial to establishing a successful treatment plan to cure the patient and consequently stop the transmission of resistant strains.
* Jarlier V and Nikaido H (1994) Mycobacterial cell wall: structure and role in natural resistance to antibiotics. FEMS Microbiol. Lett. 123:11–18.
With over 20 years of experience in mycobacteria molecular diagnostics Bruker contributes to the fight against tuberculosis (TB), NTM and leprosy. With the WHO recommendation for our comprehensive portfolio and the only Leprae diagnostic test focusing on resistance in the market our tests are designed to enable laboratories to perform reliable, user-friendly and modern diagnostics in order to heal patients and hinder the further spread of mycobacteria.
Traditional culture methods to identify TB can take up to 4 weeks for a positive result, and even 6-8 weeks for a negative result. Molecular (genetic) testing enables diagnostic labs to achieve the same results for identification for TB and NTM in under 3 hours. This means a significantly faster answer to adequate treatment of patients with a clear understanding of the underlaying resistance patterns.
The recent emergence of advanced mass spectrometry (MS) technology, specifically Matrix-Assisted Laser Desorption/Ionization Time-Of-Flight (MALDI-TOF) MS, enables clinical microbiology laboratories to master the challenge of mycobacteria identification after cultivation. The unparalleled speed of instruments, such as Bruker’s IVD-CE MALDI Biotyper® (MBT) system, in addition to enhanced ease-of-use, high specificity and significantly reduced cost per test, has seen MALDI-TOF MS emerge as a go-to technique for mycobacteria identification from culture.