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Tuberculosis in Romania

Present and expectations for rapid molecular diagnosis of TB and MDR-TB

Mihaela Tănăsescu1, Cristian Didilescu2, Constantin Marica3
1. Institutul de Pneumologie „Marius Nasta“, București; 2. Universitatea de Medicină și Farmacie Craiova; 3. Universitatea de Medicină și Farmacie „Carol Davila“, București

Tuberculosis is still one of the diseases with a major medical and social impact, and in terms of early diagnosis
(which would imply a fair treatment and established at the time), difficulties related to the delay bacilli isolation in culture, decreased susceptibility testing methods to antituberculosis drugs, lack of methods for differentiation of M. Tuberculosis complex germs of non-TB Mycobacteria, may have important clinical implications. Traditional testing of anti-TB drug susceptibility on solid Löwenstein-Jensen medium (gold standard) or liquid media can only be performed using grown samples. Determining the time it takes up to 42 days on solid media and 12 days for liquid media. For MDR/ XDR TB cases it is absolutely essential to reduce the detection time. In these
cases rapid diagnostic methods prove their usefulness. Automatic testing in liquid medium, molecular hybridization methods are currently recommended by the current WHO guidelines. Rapid diagnosis of MDR-TB is extremely useful for the early establishment of an effective treatment tailored more accurately on the spectrum of sensitivity of the resistant strain (thus reducing the risk of developing additional resistance to other drugs) and control the spread of these strains. Genetic diagnostic methods, approved and recommended
by the WHO, can reduce the time of diagnosis of TB case and, importantly, the case of MDR-TB. They do not
replace the current standard diagnostic methods and resistance profile, but complete them in selected cases.

Keywords: tuberculosis, MDR-TB, Mycobacterium tuberculosis, molecular diagnosis