Clinical evaluation of XXXX viability microscopy for assessing treatment response.

@entity1 @entity6371 @entity56921 @entity10156 @entity378
BACKGROUND:    It is difficult to determine whether early @entity378 treatment is effective and reducing the infectiousness of @entity1 ' sputum because culture takes weeks and conventional acid-fast sputum microscopy and molecular tests cannot differentiate live from dead @entity378 . METHODS:    To assess treatment response, sputum samples (n=124) from unselected @entity1 (n=35) with sputum microscopy-positive @entity378 were tested pre-treatment and after 3, 6 and 9 days of empiric first-line therapy. @entity378 quantitative viability microscopy with @entity10156 , quantitative culture and acid-fast @entity56921 -microscopy were all performed in triplicate. RESULTS:    @entity378 quantitative viability microscopy predicted quantitative culture results such that 76% of results agreed within   1 logarithm (rS=0.85, p<0.0001). In 31 @entity1 with @entity6371 , viability and quantitative culture results approximately halved (both 0.27 logarithm reduction, p<0.001) daily. For @entity1 with @entity6371 and available data, by treatment day 9 there was more than a 10-fold reduction in viability in 100% (24/24) of cases and quantitative culture in 95% (19/20) of cases. Four other @entity1 subsequently found to have @entity6371 had no significant changes in viability (p=0.4) or quantitative culture (p=0.6) results during early treatment. The change in viability and quantitative culture results during early treatment differed significantly comparing @entity1 with @entity6371 (both p<0.001). Acid-fast microscopy results changed little during early treatment and this change was similar comparing @entity1 with @entity6371 (p=0.6). CONCLUSIONS:    @entity378 quantitative viability microscopy is a simple test that within one hour predicted quantitative culture results that became available weeks later, rapidly indicating whether @entity1 were responding to @entity378 therapy.
