Diagnostic bactériologique de la tuberculose

Ziehl-Neelsen or fluorescence microscopy, culture and drug sensitivity test onto Lœwenstein-Jensen medium or with the more rapid radiometric BACTEC system are still the reference diagnostic tests for tuberculosis. However the slow growth of mycobacteria, the severity of the disease caused and the lack of a suitable sub-typing scheme for epidemiological studies have made tuberculosis a popular application for molecular techniques. The four major diagnostic areas molecular techniques have been applied for : rapid identification of cultured mycobacteria ; sub-typing of strains by a DNA fingerprinting method in contact tracing : rapid detection of antimicrobial resistance by direct DNA sequencing of target site genes, single strand conformation polymorphism analysis (PCR-SSCP) or line probe assay (LIPA) ; detection of M. tuberculosis complex in clinical material.