Species identification of non-tuberculous mycobacteria // Identificación de micobacterias no tuberculosas a nivel de especie
Resumen
Abstract
Non-tuberculous mycobacteria (NTM) prevalence has risen during recent decades. NTM species identification is crucial for treatment and epidemiologic control since, as opportunistic pathogens, they become sources of infections. Classical biochemical tests and phenotypic methods are not accurate and are time consuming. Other accurate and reliable species identification methods are available. Most are DNA-based from simple PCR-based to those more complex and high-tech based. Not all laboratories can afford technology transfer from simple to more complex and expensive methods, especially in lowincome countries. The price has dropped for some high-tech methods, hence we may think about its possible widespread use, even though some limitations exist regarding data analysis and skill acquisitions. The identification of NTM has been problematic due to their evolving taxonomy, limitations of current phenotypic methods, and absence of a universal gene target for reliable speciation. Accurate NTM identification is a challenging task in diagnostic laboratories due to the absence of a universal robust method and to the difficulty to distinguish between closely related species. This work reviews the most commonly available methods for NTM species identification nowadays.
Resumen
La prevalencia de las micobacterias no tuberculosas (MNT) se ha incrementado durante las recientes décadas. La identificación de las MNT a nivel de especies es crucial tanto para el tratamiento como para el control epidemiológico, debido a que son patógenos oportunistas y se vuelven fuentes de infección. Las pruebas bioquímicas clásicas y los métodos fenotípicos no son precisos y consumen un tiempo considerable para obtener resultados. Existen métodos precisos y confiables, la mayoría moleculares, desde aquellos basados en PCR hasta otros más complejos de alta tecnología. No todos los laboratorios pueden costear una transferencia de tecnología de métodos simples a más complejos y costosos, sobre todo en países con bajos recursos. El precio ha caído para algunos métodos tecnológicamente avanzados, por lo que se pudiera pensar en su amplio uso, aunque todavía existen limitantes en relación al análisis de datos y la adquisición de destrezas. La identificación de MNT ha sido problemática debido a: una taxonomía en constante evolución, limitaciones de los métodos fenotípicos actuales y la ausencia de un marcador genético universal para una especiación confiable. La identificación precisa de MNT es una tarea desafiante en los laboratorios que hacen diagnóstico debido a la ausencia de un método robusto universal y a la dificultad de distinguir entre especies estrechamente relacionadas. Este trabajo revisa los métodos más comunes disponibles para la identificación de las especies de MNT hasta el presente.
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