Division of Clinical Microbiology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand.
Division of Clinical Immunology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand.
Appl Microbiol Biotechnol. 2024 Sep 2;108(1):456. doi: 10.1007/s00253-024-13293-1.
The diagnosis of mycobacterial infections, including both the Mycobacterium tuberculosis complex (MTBC) and non-tuberculous mycobacteria (NTM), poses a significant global medical challenge. This study proposes a novel approach using immunochromatographic (IC) strip tests for the simultaneous detection of MTBC and NTM. Traditional methods for identifying mycobacteria, such as culture techniques, are hindered by delays in distinguishing between MTBC and NTM, which can affect patient care and disease control. Molecular methods, while sensitive, are resource-intensive and unable to differentiate between live and dead bacteria. In this research, we developed unique monoclonal antibodies (mAbs) against Ag85B, a mycobacterial secretory protein, and successfully implemented IC strip tests named 8B and 9B. These strips demonstrated high concordance rates with conventional methods for detecting MTBC, with positivity rates of 93.9% and 85.9%, respectively. For NTM detection, the IC strip tests achieved a 63.2% detection rate compared to culture methods, considering variations in growth rates among different NTM species. Furthermore, this study highlights a significant finding regarding the potential of MPT64 and Ag85B proteins as markers for MTBC detection. In conclusion, our breakthrough method enables rapid and accurate detection of both MTBC and NTM bacteria within the BACTEC MGIT system. This approach represents a valuable tool in clinical settings for distinguishing between MTBC and NTM infections, thereby enhancing the management and control of mycobacterial diseases. KEY POINTS: • Panel of mAbs for differentiating MTB versus NTM • IC strips for diagnosing MTBC and NTM after the BACTEC MGIT • Combined detection of MTP64 and Ag85B enhances diagnostic accuracy.
分枝杆菌感染的诊断，包括结核分枝杆菌复合群（MTBC）和非结核分枝杆菌（NTM），是一个全球性的医学挑战。本研究提出了一种新的方法，使用免疫层析（IC）条带试验同时检测 MTBC 和 NTM。传统的分枝杆菌鉴定方法，如培养技术，受到区分 MTBC 和 NTM 的延迟的阻碍，这可能影响患者的护理和疾病控制。分子方法虽然敏感，但资源密集且无法区分活细菌和死细菌。在这项研究中，我们开发了针对分枝杆菌分泌蛋白 Ag85B 的独特单克隆抗体（mAb），并成功实施了命名为 8B 和 9B 的 IC 条带试验。这些条带与传统的 MTBC 检测方法具有高度一致性，阳性率分别为 93.9%和 85.9%。对于 NTM 的检测，与培养方法相比，IC 条带试验的检测率为 63.2%，考虑到不同 NTM 物种的生长速度差异。此外，本研究强调了 MPT64 和 Ag85B 蛋白作为 MTBC 检测标志物的潜力。总之，我们的突破性方法能够在 BACTEC MGIT 系统中快速准确地检测 MTBC 和 NTM 细菌。这种方法代表了临床环境中区分 MTBC 和 NTM 感染的有价值的工具，从而增强了分枝杆菌病的管理和控制。 关键点： • 用于区分 MTB 与 NTM 的 mAb 面板 • BACTEC MGIT 后用于诊断 MTBC 和 NTM 的 IC 条带 • 联合检测 MTP64 和 Ag85B 提高了诊断准确性。
