Category | Tuberculosis (TB) | Pulmonary Non-tuberculous mycobacteria (NTM) infections | References |
---|---|---|---|
1. Causative agent | M. tuberculosis complex organisms | M. avium complex. M. abscessus, M. kansasii, M. malmoense, M. xenopi | |
2. Mode of transmission | Inhalation of contaminated aerosols from patients with pulmonary TB | Primarily acquired from the environment - lack of person-to-person transmission | |
3. Sex with higher disease burden | Male | Female | |
4. Predisposition/Co-morbidities | HIV, DM, Immunosuppression | Bronchiectasis, Previous history of TB, CF, COPD | |
5. Diagnosis | |||
5.1 Clinical | Lung involvement, alveolar infiltration, cavitation, lymphadenopathy and pleural effusion | Nodular or cavitary opacities on chest radiograph, or an HRCT scan that shows multifocal bronchiectasis with multiple small nodules | |
5.2 Radiological | X-ray; rarely CT | X-ray; PET/CT or HRCT | |
Samples for the diagnostic test | Sputum samples, bronchial or bronchioalveolar lavage aspirates, or tracheal aspirates; Gastric aspirate | Sputum, bronchial wash, or lavage; Gastric aspirate not preferred due to failure to indicate active pNTM disease | |
5.3 Microbiological test | |||
5.3.1 Staining | Acid fast staining; Ziehl Neelson staining | Acid fast staining; Ziehl Neelson staining | |
5.3.2 Culture | Solid, Liquid - MGIT 960 system; the VersaTREK system; MB/BacT Alert 3D | Solid or liquid including MGIT but with PNB | |
5.4 Molecular biological test | TB Ag MPT64 RAPID Nucleic acid amplification test (NAAT) – Amplified Mycobacterium tuberculosis direct (MTD); Amplicor Mycobacterium tuberculosis Test; Xpert MTB-Rif system; Xpert MTB-Rif Ultra Loop-mediated isothermal amplification (LAMP)-based MTB detection system; Cross-priming amplification (CPA)-based TB diagnostic system; CE-IVD Genedrive; Anyplex II MTB/MDR and MTB/XDR; Anyplex MTB/NTM MDR-TB kit; EZplex MTBC/NTM; VereMTB Detection Kit Line probe assays (LiPA) – Inno-LiPA Mycobacteria assay; Genotype Mycobacterium CM and AS assays Others - MALDI-TOF Next gen sequencing For Latent TB – Tuberculin skin test IGRA test - QuantiFERON-TB Gold, QFT-GIT, QFT-Plus and T-SPOT.TB | TB Ag MPT64 RAPID – to differentiate M. tb complex from NTM HPLC PCR-RFLP ; PCR sequencing NAATs – Accuprobe analysis Anyplex MTB/NTM MDR-TB EZplex MTBC/NTM; Genedia MTB/NTM Detection Kit LiPAs – Inno-LiPA Mycobacteria assay; GenoType Mycobacterium CM -AS Others - MALDI-TOF Next gen sequencing | PCR-RFLP/Sequencing - [31,32,33,34] NAAT – [35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53] LIPA – Others – LTBI – |