다제내성결핵 균주에서 Reverse Hybridization Assay를 이용한 Fluoroquinolone, Kanamycin 신속 내성 검사의 유용성

Multidrug-resistant tuberculosis (MDR-TB) is an increasing public health problem and poses a serious threat to global TB control. Fluoroquinolone (FQ) and aminoglycoside (AG) are essential anti-TB drugs for MDR-TB treatment. REBA MTB-FQ? and REBA MTB-KM? (M&D, Wonju, Korea) were evaluated for ra...

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Published in:Tuberculosis and respiratory diseases 2012, 72(1), 324, pp.44-49
Main Authors: 박진수, Chin Su Park, 성낙문, Nack Moon Sung, 황수희, Soo Hee Hwang, 전재현, Jae Hyun Jeon, 원영섭, Young Sub Won, 민진홍, Jin Hong Min, 김천태, Cheon Tae Kim, 강형석, Hyung Seok Kang
Format: Article
Language:Korean
Subjects:
Microbial
Mycobacterium tuberculosis
Mutation
Tuberculosis
Fluoroquinolones
Kanamycin
Drug Resistance
내과학
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Summary:Multidrug-resistant tuberculosis (MDR-TB) is an increasing public health problem and poses a serious threat to global TB control. Fluoroquinolone (FQ) and aminoglycoside (AG) are essential anti-TB drugs for MDR-TB treatment. REBA MTB-FQ? and REBA MTB-KM? (M&D, Wonju, Korea) were evaluated for rapid detection of FQ and kanamycin (KM) resistance in MDR-TB clinical isolates. M. tuberculosis (n=67) were isolated and cultured from the sputum samples of MDR-TB patients for extracting DNA of the bacilli. Mutations in genes, gyrA and rrs, that have been known to be associated with resistance to FQ and KM were analyzed using both REBA MTB-FQ? and REBA MTB-KM?, respectively. The isolates were also utilized for a conventional phenotypic drug susceptibility test (DST) as the gold standard of FQ and KM resistance. The molecular and phenotypic DST results were compared. Sensitivity and specificity of REBA MTB-FQ? were 77 and 100%, respectively. Positive predictive value and negative predictive value of the assay were 100 and 95%, respectively, for FQ resistance. Sensitivity, specificity, positive predictive value and negative predictive value of REBA MTB-KM? for detecting KM resistance were 66%, 94%, 70%, and 95%, respectively. REBA MTB-FQ? and REBA MTB-KM? evaluated in this study showed excellent specificities as 100 and 94%, respectively. However, sensitivities of the assays were low. It is essential to increase sensitivity of the rapid drug resistance assays for appropriate MDR-TB treatment, suggesting further investigation to detect new or other mutation sites of the associated genes in M. tuberculosis is required.
ISSN:1738-3536
2005-6184