Identification and resistance detection of mycobacteria


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.

The mycobacteria challenge

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.

Fast answers with molecular diagnostics

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.

Rapid and highly specific identification from culture, by MALDI-TOF

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.

Multidrug-resistant tuberculosis (MDR-TB) is an alarming and ongoing global issue which requires fast intervention in order to prevent further spread of the disease. Committed to jointly fighting TB worldwide the WHO approves and recommends FluoroType® MTBDR V2.0.