Rapid TB Laboratory Diagnosis Service

	Fast Track

	Objectives	Report
	Delivery of Clinical Sample	Committee
	Examining Processes	Staffs

Tuberculosis (TB) causes 3 millions deaths per year globally and is the leading cause of death from infectious diseases in Thailand. The AIDS epidemic strategy strongly increases drug-resistant TB crisis at present. Not only the AIDS epidemic and drug-resistant TB infection, but also poverty, lack of continuous treatment, and inadequate laboratory diagnosis of tuberculosis may influence the increase in drug-resistant tuberculosis in the future.

Rapid, accurate and precise laboratory diagnosis is very important to help TB patients to be treated with appropriate chemotherapy. Moreover, the right information helps reduce the cost of treatment and will reduce the TB problem by helping prevent the TB epidemic, especially of drug-resistant TB.

The TB germ (Mycobacterium tuberculosis) is a slow-growing bacterium. It needs 1-2 months to grow this bacteria in a culture. Approximately 5-10 % of TB infected persons develop TB disease. The target usually attacked is the lung, from which the germ can invade other organs if the infected persons have a weak immune system. Other bacteria in the Mycobacterium group can cause disease with similar symptoms as TB in people with defective immune function, especially those infected with HIV . The present method of laboratory diagnosis is based on identification of bacteria cultivated from the patient’s specimen. Although this is the most accurate identification method, it takes about 2-4 months to get the results. This affects the treatment plan.

The Rapid TB Laboratory Diagnosis Service (Fast Track) was established by the cooperation of the National Center for Genetic Engineering and Biotechnology (BIOTEC), the National Science and Technology Development Agency (NSTDA) and the Faculty of Medicine at Siriraj Hospital, Mahidol University.

The service includes both molecular techniques developed in house supported by the NSTDA and Mahidol University and an automatic culture system for laboratory diagnosis of tuberculosis. The service involves:

Microscopic examination
Direct detection of genetic material
Detection and isolation with an automatic culture system
Species identification by gene detection
An antimycobacterial susceptibility test

All these results are reported within one month compared with 2-4 month using conventional methods.

The Advantage of the TB Fast Track Services are:

provides a rapid diagnosis
provides information about the susceptibility of the etiologic mycobacteria
an appropriate regimen can be chosen for the patient and this helps to reduce the transmission rate
can collect and analyse all data concerning drug-resistant TB in Thailand and can record as a reference which is useful for all physicians to use as a tool in the prevention and treatment of the disease in patients for whose they are responsible.