Use of a molecular diagnostic test in AFB smear positive tuberculosis suspects greatly reduces time to detection of multidrug resistant tuberculosis

The WHO has recommended the implementation of rapid diagnostic tests to detect and help combat M/XDR tuberculosis (TB). There are limited data on the performance and impact of these tests in field settings. The performance of the commercially available Genotype MTBDRplus molecular assay was compared...

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Bibliographic Details
Published in:PloS one 2012-02, Vol.7 (2), p.e31563-e31563
Main Authors: Tukvadze, Nestani, Kempker, Russell R, Kalandadze, Iagor, Kurbatova, Ekaterina, Leonard, Michael K, Apsindzelashvili, Rusudan, Bablishvili, Nino, Kipiani, Maia, Blumberg, Henry M
Format: Article
Language:English
Subjects:
Air bases
Antitubercular agents
Antitubercular Agents - pharmacology
Assaying
Biology
Chemotherapy
Clinical outcomes
Codons
Diagnostic systems
Diagnostic tests
Disease control
Drug resistance
Genotype & phenotype
Georgia
Hepatitis
Humans
Infectious diseases
Isoniazid
Isoniazid - pharmacology
Laboratories
Lung diseases
Medical diagnosis
Medical screening
Medicine
Microscopy
Molecular Diagnostic Techniques - methods
Multidrug resistance
Multidrug resistant organisms
Mutation
Mycobacterium tuberculosis
Reproducibility of Results
Rifampin
RpoB protein
Smear
Sputum
Sputum - microbiology
Tuberculosis
Tuberculosis, Multidrug-Resistant - diagnosis
Tuberculosis, Multidrug-Resistant - genetics
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Summary:The WHO has recommended the implementation of rapid diagnostic tests to detect and help combat M/XDR tuberculosis (TB). There are limited data on the performance and impact of these tests in field settings. The performance of the commercially available Genotype MTBDRplus molecular assay was compared to conventional methods including AFB smear, culture and drug susceptibility testing (DST) using both an absolute concentration method on Löwenstein-Jensen media and broth-based method using the MGIT 960 system. Sputum specimens were obtained from TB suspects in the country of Georgia who received care through the National TB Program. Among 500 AFB smear-positive sputum specimens, 458 (91.6%) had both a positive sputum culture for Mycobacterium tuberculosis and a valid MTBDRplus assay result. The MTBDRplus assay detected isoniazid (INH) resistance directly from the sputum specimen in 159 (89.8%) of 177 specimens and MDR-TB in 109 (95.6%) of 114 specimens compared to conventional methods. There was high agreement between the MTBDRplus assay and conventional DST results in detecting MDR-TB (kappa = 0.95, p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0031563