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Journal of Clinical Microbiology, March 1999, p. 518-523, Vol. 37, No. 3
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Detection of Viable Mycobacterium tuberculosis by Reverse Transcriptase-Strand Displacement Amplification of mRNA

T. J. Hellyer,1,dagger L. E. DesJardin,1,Dagger L. Teixeira,2 M. D. Perkins,2 M. D. Cave,3 and K. D. Eisenach1,4,*

Departments of Pathology,1 Microbiology/Immunology,4 and Anatomy,3 University of Arkansas for Medical Sciences, Little Rock, Arkansas, and Duke University Medical Center/Universidade Federal do Espirito Santo, Vitória, Brazil2

Received 27 August 1998/Returned for modification 22 November 1998/Accepted 7 December 1998

Numerous assays have been described for the detection of DNA and rRNA sequences that are specific for the Mycobacterium tuberculosis complex. Although beneficial to initial diagnosis, such assays have proven unsuitable for monitoring therapeutic efficacy owing to the persistence of these nucleic acid targets long after conversion of smears and cultures to negative. However, prokaryotic mRNA has a typical half-life of only a few minutes and we have previously shown that the presence of mRNA is a good indicator of bacterial viability. The purpose of the present study was to develop a novel reverse transcriptase-strand displacement amplification system for the detection of M. tuberculosis alpha -antigen (85B protein) mRNA and to demonstrate the use of this assay in assessing chemotherapeutic efficacy in patients with pulmonary tuberculosis. The assay was applied to sequential, noninduced sputum specimens collected from four patients: 10 of 11 samples (91%) collected prior to the start of therapy were positive for alpha-antigen mRNA, compared with 1 of 8 (13%), 2 of 8 (25%), 2 of 8 (25%), and 0 of 8 collected on days 2, 4, 7, and 14 of treatment, respectively. In contrast, 39 of 44 samples (89%) collected on or before day 14 were positive for alpha -antigen DNA. The loss of detectable mRNA corresponded to a rapid drop over the first 4 days of treatment in the number of viable organisms present in each sputum sample, equivalent to a mean fall of 0.43 log10 CFU/ml/day. Analysis of mRNA is a potentially useful method for monitoring therapeutic efficacy and for rapid in vitro determination of drug susceptibility.

* Corresponding author. Mailing address: John L. McClellan Memorial Veterans' Hospital, Slot-151, 4300 West 7th St., Little Rock, AR 72205. Phone: (501) 257-4827. Fax: (501) 664-6748. E-mail: eisenachkathleend{at}exchange.uams.edu.

dagger Present address: Becton Dickinson Microbiology Systems, Sparks, Md.

Dagger Present address: University of Iowa, Iowa City, Iowa.

Journal of Clinical Microbiology, March 1999, p. 518-523, Vol. 37, No. 3
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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