Direct tuberculosis drug susceptibility testing: time-saving and cost-effective in detecting MDR-TB

BACKGROUND: Recent advances have made molecular diagnosis of tuberculosis (TB) and drug susceptibility testing (DST) possible, but the high costs involved present a huge challenge. The refinement and improvement of affordable methods therefore remain a priority. Conventional indirect DST is inexpens...

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Bibliographic Details
Published in:The international journal of tuberculosis and lung disease 2016-03, Vol.20 (3), p.323-328
Main Authors: Zhang, T., Lv, C-F., Wang, J., Zheng, W-B, Lu, L-Z., Liu, S-J., Bao, J.
Format: Article
Language:English
Subjects:
Antitubercular Agents - therapeutic use
China
Cost-Benefit Analysis
Dr-Tb
Drug Resistance, Bacterial
Dst
Humans
isoniazid
Isoniazid - therapeutic use
Microbial Sensitivity Tests - economics
Multidrug-Resistant Tb
Mycobacterium
Mycobacterium tuberculosis - drug effects
rifampicin
Rifampin - therapeutic use
Specimen Handling
Sputum - drug effects
Sputum - microbiology
Tuberculosis
Tuberculosis, Multidrug-Resistant - diagnosis
Tuberculosis, Multidrug-Resistant - drug therapy
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Summary:BACKGROUND: Recent advances have made molecular diagnosis of tuberculosis (TB) and drug susceptibility testing (DST) possible, but the high costs involved present a huge challenge. The refinement and improvement of affordable methods therefore remain a priority. Conventional indirect DST is inexpensive and reliable, but time-consuming. A direct DST method for the direct testing of sputum samples without culture has been developed to reduce the time required for DST, but there have been conflicting results.METHODS AND RESULTS: Direct and indirect DST against isoniazid and rifampicin were performed on 208 sputum smear-positive specimens, 186 from newly diagnosed patients and 22 from previously treated patients; respectively 169 and 180 of the direct and indirect DST results were reportable. In comparison with indirect DST, direct DST resulted in a saving of on average 10.5 days. The time to direct DST results was inversely correlated with the number of acid-fast bacilli in the sputum samples.CONCLUSION: Direct DST is highly sensitive, reliable, cost-effective and time-saving in comparison with indirect DST.
ISSN:1027-3719
1815-7920
DOI:10.5588/ijtld.15.0637