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Identification of Mycobacterium species in FFPE granulomatous lymphadenitis tissue using REBA Myco-ID(®)

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease | 30 Apr 2013

J Munkhdelger, HY Wang, Y Choi, PM Wairagu, D Lee, S Park, S Kim, BY Jeon, H Lee and KH Park
Abstract
SETTING: Tuberculous lymphadenitis is the most common form of lymphadenopathy; its main histopathological finding is granulomatous inflammation.OBJECTIVE: A reverse blot hybridisation assay, REBA Myco-ID(®), was applied to formalin-fixed paraffin-embedded (FFPE) tissue showing granulomatous lymphadenitis to define the causative agents.DESIGN: A total of 119 granulomatous lymphadenitis cases observed between 2000 and 2010 were studied. All tissue samples were treated by haematoxylin and eosin and Ziehl-Neelsen stain. Mycobacterium tuberculosis and non-tuberculous mycobacteria (NTM) were identified using the REBA Myco-ID assay, and resistance to rifampicin (RMP) and isoniazid (INH) was determined using REBA MTB-MDR(®).RESULTS: Of the 119 cases, 113 (95%) were positive with the REBA Myco-ID assay, while 20 (16.8%) were positive on acid-fast bacilli smear. Of the 113 positive REBA Myco-ID cases, 110 (92.43%) were identified as M. tuberculosis, 2 (1.7%) as NTM, and 1 (0.8%) as coinfection with M. tuberculosis and M. chelonae. Only 1 (0.9%) of the 110 M. tuberculosis cases was identified as RMP-resistant.CONCLUSION: REBA Myco-ID is a highly sensitive and specific assay for detecting M. tuberculosis and NTM. M. tuberculosis is the main cause of granulomatous lymphadenitis.
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Concepts
Staining, Microbiology, Leprosy, Acid fast bacilli, Mycobacterium tuberculosis, Ziehl-Neelsen stain, Mycobacterium, Tuberculosis
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