MYCOBACTERIOSIS

DIAGNOSIS

- Modern methods of laboratory diagnosis have allowedsignificantly improve the accuracy, efficiency, and speed of detection and determination of mycobacterial type. But even with the use of highly accurate methods, an important criterion for quality is the qualification of the specialist who conducts the examination. In microscopic examination, it is important to consider many nuances, for example, that a sputum sample may contain bacteria from the surface of the tracheal mucosa and oral cavity.

- On differentiation of mycobacterioses based on laboratory testing. In turn, establishing the type of mycobacteria helps determine which medications they are resistant to and which can effectively cure the patient.

- Methods of diagnosis and treatment of mycobacteriosis are selected by the attending physician after a full examination, collection and review of medical history

Unfortunately, there is no single sign that is characteristic of of this disease alone.

Clinically, radiologically and histologically, mycobacterioses are very similar to tuberculosis, and only bacteriological and molecular genetic methods allow a definitive diagnosis.

Diagnosis of mycobacterioses has much in common with tuberculosis testing and is usually performed simultaneously with tuberculosis diagnosis in tuberculosis facilities.

But there are important features of the laboratory tests and interpretation of the results."

Possible transient colonization of mucous membranes of the upper respiratory NTMs from the environment, due to which isolation of microorganisms of this group is not always is not always a criterion for diagnosis.

-An assessment of clinical significance is important inthe following cases:

-Repeated isolation of NTMs fromlower respiratory tract in 74% of casesis a reason to make the diagnosis.

-Nonpathogenic NTMs are isolated from urine in 90% of cases.Nonpathogenic NTM and other acid- fastmicroorganisms

In order to make a diagnosis of "Mycobacteriosis" requires isolation of the same species ofNTM at least twice from the same patient, taking into account the fact that examination is prescribed in the presence of presence of symptoms disease."

But there are exceptions when a single isolation of NTM is sufficient for etiological confirmation of the diagnosis of "mycobacteriosis". This is possible if: NTMs have been isolated from a sample obtained under sterile conditions from a closed nidus (abscess, biopsy, surgical material). NTMs are isolated from a sample of normally sterile tissue or fluid (bone marrow, blood, cerebrospinal fluid)

In order to make a correct diagnosis and the prescription of adequate treatment, it is extremely It is critical not only to identify NTMs, but also to determine their species identity and drug sensitivity.This requires state-of-the-art high-tech equipment and qualified personnel in the microbiological laboratory

"The prescription of therapy is necessary when there is marked symptomatology of the disease and mycobacteriological aspects of mycobacteriosis have been determined. The treatment of mycobacteriosis is even more complex than that of tuberculosis. It requires the prescription of multicomponent chemotherapy with a long course duration (at least 6 to 12 months). Mycobacteriosis chemotherapy should be based on determining the drug sensitivity of NTMs, which will lead to improved treatment efficacy.

tuberculo sis

sarcoidosis	Carcinomato
	sis

silicotuberculos cardiogenic

Determination of granulomatosis pathogens should be performed sequentially, because each of the methods has distinctive properties and limits of possibilities, dictating the role in the necessity of subsequent studies.Histobacterioscopic methods determine the family of the pathogen (acid-fast bacteria). Immunohistochemical method determines the genus Mycobacteria, but does not identify theirspecies. Real-time PCR allows to determine the species identity of mycobacteria (tuberculous and non-tuberculous mycobacteria), quantitative characterization of their DNA, which can provide to monitor the effectiveness of eradication of the pathogen

COMPREHENSIVE MORPHOLOGICAL EXAMINATIO

OF THE MATERIAL

●MACROSCOPIC PICTURE

●CYTOLOGICAL EXAMINATION

●MICROSCOPIC CHARACTERIZATION

●ADDITIONAL HISTOLOGICAL STAINS (INCLUDING HISTOBACTERIOSCOPY)

●IMMUNOHISTOCHEMICAL IMMUNOHISTOCHEMICAL ANALYSIS FOR THE DETECTION OF INFECTIOUS ANTIGEN

●PCR FOR DNA DETECTION