Dr. Max Salfinger stresses the need for shorter diagnosis times for drug-resistant tuberculous and pulmonary nontuberculous mycobacterial diseases

| Academic & Student Affairs, COPH Office of Research, Featured News, Monday Letter, Our Research, Public Health Practice

USF College of Public Health’s Dr. Max Salinger, professor and co-lead of the DrPH public health and clinical laboratory science and practice program, and colleagues have honed in on several new ways to diagnose and shorten the time it takes to accurately diagnose drug-resistant tuberculous and pulmonary nontuberculous mycobacterial (NTM) disease. These are diseases requiring several months of treatment with multiple antibiotics.

Their work, “Novel Assays/Applications for Patients Suspected of Mycobacterial Diseases,” has been published in Clinics in Laboratory Medicine.

According to Salfinger, the World Health Organization and the Centers for Disease Control and Prevention, together with many other organizations worldwide, are working toward the elimination of tuberculosis.

“In 2019, there were almost 9,000 patients in U.S. reported with tuberculosis, and worldwide the number is estimated as ten million,” he said. “My commitment towards tuberculosis elimination started when I became, in 1981, the director of the tuberculosis laboratory at the University of Zurich, Switzerland and realized the importance of a state-of-the-art diagnostic laboratory testing and its contribution toward tuberculosis elimination.”

Max Salfinger, MD, FIDSA, FAAM. (Photo courtesy of USF)

“Novel laboratory tests often provide shorter turnaround times for critical results. The earlier a tuberculosis patient is diagnosed and treated, the faster the transmission of tuberculosis bacteria from person to person is interrupted,” he said.

According to the Salfinger and his colleagues, mycobacteria are the causative organisms for diseases such as tuberculosis, leprosy, Buruli ulcer, and pulmonary NTM disease.

“In our publication, we also highlighted pulmonary NTM disease which, until recently, was even considered an orphan disease,” Salfinger said. “However, this disease is an emerging public health challenge.”

According to Salfinger, the U.S. National Institutes of Health reported an increase of 8.2 percent per year from 1997 to 2007 of pulmonary NTM disease among adults ages 65 years or older, with women being more affected than men.

“The most frequently encountered NTM are Mycobacterium avium complex and Mycobacterium abscessus,” Salfinger said. “These mycobacteria live in the environment, especially water and soil.”

Mycobacterium tuberculosis bacteria. (Photo source: NIAID)

These increases in cases are exactly why, according to Salfinger, new, novel approaches to diagnosing TB, including drug-resistant TB, incipient TB, and pulmonary NTM disease and its molecular drug resistance markers earlier on is key.

“People react differently to change; some embrace it right away while others resist if they can,” Salfinger said.

In addition to spreading the word about new ways to more quickly and accurately diagnose these infections, Salfinger said he and his colleagues hope to take their research a step further.

“Since Florida is a hotspot for NTM disease, we are seeking funding for better NTM diagnostics and  to learn more about a potential correlation between drinking water and pulmonary NTM disease, especially in people with cystic fibrosis,” he said.

Story by Anna Mayor, USF College of Public Health