الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Mycobacterial infections continue to cause high morbidity and mortality. According to the latest WHO statistics in 2015, there are 9.6 million people infected with TB globally, and 15 in every 100,000 people are infected with TB in Egypt. In the year 2014, about 1.5 million people died of TB worldwide.
TB is a public health problem in the developing world. It remains a main threat to mankind, ranking at the 8 th position of all causes of deaths in low-income countries.
Although AFB microscopy, and conventional LJM culture are the cornerstone of the diagnosis of TB, these traditional bacteriological methods are either slow or their sensitivity is quite low, especially with clinical samples that contain small number of organisms. This can affect treatment by either delaying it or causing inappropriate empiric therapy for TB to subjects without mycobacterial infections or with atypical mycobacteria.
Thus rapid detection and identification of M. tuberculosis is essential both for medical and epidemiological purposes. Under these circumstances, there is a need of a culture method that is reliable and has a short turnaround time.
An accurate, rapid, inexpensive, and technically simple method for M. tuberculosis drug susceptibility testing is needed for areas with high rates of MDR TB.
MODS system is a fast and a low-cost tool that provide rapid, efficient detection of M. tuberculosis and drug susceptibility test at the same time, for RIF and INH antituberculous drugs that has tremendously exciting potential for future use in high-burden, resource-poor countries.
The present study aimed to:
3. To evaluate MODS technique for diagnosis of pulmonary TB.
4. To compare between results of ZN staining, culture and MODS for diagnosis of pulmonary TB.
The study was conducted during a 6 months period, at the Maamorah Chest Hospital in Alexandria and included 100 clinically and/or radiologically suspected PTB patients.
The results of this study showed that:
1. Fourteen patients had smear positive culture results for mycobacteria, while eighteen patients had MODS positive result and thirteen patients had positive LJ culture.
2. The highest percentage of culture positive patients was in the age group 40 to less than 60 years (50%).
3. Fourteen (77.8%) out of 18 culture positive patients were males, while only 4 (22.2%) of them were females.
4. Out of 14 smear positive sputum samples, only 10 were positive on LJM and 11 were positive by MODS.
5. Out of 86 smear negative sputum samples, only 3 grew on LJM and 7 grew on MODS.
6. MODS and LJM were positive in 13 samples with positive predictive value 100%, and both were negative in 82 samples with negative predictive value 94.25%.
7. MODS were positive in 5 samples that were negative on LJM with overall accuracy of 95%.
8. There was perfect agreement between direct smear and MODS (Kappa=0.629), and the proportion of specific agreement was 94.05% for negative agreement, and that of positive agreement was 68.57%.
9. There was perfect raw agreement between LJM and MODS technique (Kappa=0.810), and the proportion of specific agreement was 97.04% for negative agreement, and that of positive agreement was 83.87%.
10. The mean time for detection of M. tuberculosisby MODS (13.00±4.20 days) was statistically shorter than that of LJM (36.69±11.65days).
11. The mean time for detection of M. tuberculosison LJM was 34.2 days for smear +ve samples and 45 days for smear-ve samples.
12. Three MTB isolates showed drug resistance by MODS. one sample was resistant to Rif alone (5.5%), one sample was resistant to INH alone (5.5%), and one sample (5.5%) was resistant to both.