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Mar 24

Tuberculosis: still stuck in Victorian times?

Surprisingly for what many consider to be a long-dead Victorian disease, tuberculosis (TB) remains a problem in the UK and the message of this World TB Day (24 March 2016) “Unite to End TB” is still relevant.

world tb dayThe number of cases within the UK has risen over the last 30 years and, although numbers are now starting to fall from their highest levels in 2011 (over 8,000 cases), the incidence of the disease remains high. The UK still has the second highest rate of TB in Western Europe and TB is almost five times as prevalent here as in the US. Of further concern are the increasing numbers of drug-resistant TB cases, which currently account for about 1.5 % of occurrences in the UK.

If the current pandemic is to be brought under control, accurate and rapid diagnosis – alongside methods for monitoring resistance to therapeutic agents and disease spread throughout the community – is needed.

LGC scientists have just completed a major European project (Infect-Met) working in these areas which will ultimately lead to more robust and comparable diagnosis and monitoring of infectious diseases and antibiotic resistance.

To improve accuracy of TB diagnosis and determine the levels of the pathogen present, LGC scientists have investigated the capability of molecular methods currently used in clinical analysis. A high sensitivity digital polymerase chain reaction (dPCR) method for accurate quantification of Mycobacterium tuberculosis (the bacteria which cause TB) was developed and evaluated for value-assignment by several National Measurement Institute laboratories. The results were highly reproducible, demonstrating the potential of this method as a reference method to support standardisation of disease measurements. To compare and assess the performance of clinical assays for TB analysis, dPCR value-assigned test materials were sent to different laboratories around the world, the results of which highlighted the performance of current molecular methods including the World Health Organisation-approved assay for TB diagnosis.

In addition, LGC has been working in collaboration with University College London’s (UCL) Centre for Clinical Microbiology and the London School of Hygiene and Tropical Medicine to improve the detection of drug-resistant forms of TB, assessing the performance of commercial DNA extraction kits and developing novel sequencing approaches to detect drug resistant forms. The knowledge gained from these experiments will help to inform the sensitivity, accuracy and reproducibility of these techniques for strain surveillance, monitoring of antibiotic resistance and the emergence of new mutations giving rise to further antibiotic resistance.

As a result of the work performed in this European project, LGC has provided support to both industry and academia: improving confidence in kits for TB diagnosis and helping standardise sample processing protocols for improving clinical evaluation of molecular methods to aid research and ultimately patient testing.

The work done by LGC on improving methods both for diagnosis of tuberculosis and monitoring drug resistance could ultimately support the 2015 Public Health England initiative to wipe out tuberculosis in the UK.

 

If you would like to find out more, please read our papers on dPCR absolute quantification of TB and the standardization of nucleic acid tests for clinical measurements of bacteria and viruses.

 

LGC, the UK’s Designated Institute for chemical and bio-measurement

 

 

1 comment

  1. ALS Water Testing (@ALSwater1)

    Frightening to think diseases such as TB are making a resurgence in the modern world!

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