Viability of high performance liquid chromatography as a method of mycobacterial identification in South African laboratories
Date
2001
Authors
Naidoo, Shirona
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Abstract
Pathogenic mycobacterial infection was in recent decades a health concern so well controlled that eradication seemed imminent. However, it is once again reaching epidemic proportions following the increasing prevalence of AIDS. One important means of curbing this resurgence, is a robust method that has the capability of identifying to a species level speciating disease causing mycobacteria in a matter of days. Several new methodologies are now available that enable dramatic reductions in turn-around times.
In this study High Performance Liquid Chromatography was investigated to determine how this system compared with the current mycobacterial system of methodologies adopted in South African laboratories.
Four species of pathogenic mycobacteria, with a high prevalence in South Africa, were tested in a sample size of 80. Samples were subjected to HPLC, Gene Probes and Biochemical testing. HPLC was the most capable of identifying the mycobacteria to species level displaying a sensitivity to the organisms of 96.25 %. Gene probes and Biochemical testing had sensitivity values of 82.5 % and 80 % respectively.
HPLC was also more cost efficient and displayed a wider range of identification. It is therefore suggested that HPLC replace Gene probes and Biochemical testing for purposes of MOTT identification in the comprehensive mycobacterial identification system. The result is a time saving of at least 3 weeks and a cost reduction of approximately 30 %.
The large initial capital investment required for the implementation of the HPLC system is justified by the long term cost saving as well as the additional utility derived from early identification. As a consequence treatment is not empiric but rather tailored to the organism infecting the patient, hence preventing multiple drug resistance developing and ultimately saving a life through rational drug use.
Description
A research report Submitted to the faculty of Health Sciences, University of Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Masters of Science in Medicine (Pharmaceutical Affairs).