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

PloS One
Nestani TukvadzeHenry M Blumberg

Abstract

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<0.01). The most prevalent INH resistance mutation was S315T (78%) in the katG codon and the most common rifampicin resistance muta...Continue Reading

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Citations

Feb 9, 2013·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Lana DinicPhyllis J Kanki
Mar 11, 2015·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Jennifer K FredianiThomas R Ziegler
May 7, 2013·The Annals of Thoracic Surgery·Sergo VashakidzeRussell R Kempker
Oct 20, 2015·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·E ChiappiniUNKNOWN Italian Pediatric TB Study Group
Nov 18, 2015·BMC Infectious Diseases·Mahfuza RifatAbul Hasnat Milton
Aug 8, 2015·Emerging Microbes & Infections·Jessica N TorresFaramarz Valafar
Aug 5, 2015·Bulletin of the World Health Organization·Medea GegiaHenry M Blumberg
Mar 20, 2012·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Medea GegiaHenry M Blumberg
Aug 6, 2014·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Maia KipianiRussell R Kempker
Oct 21, 2014·PloS One·Jennifer K FredianiThomas R Ziegler
Sep 25, 2015·The American Journal of Clinical Nutrition·Nestan TukvadzeThomas R Ziegler
Mar 18, 2015·Antimicrobial Agents and Chemotherapy·Russell R KempkerHenry M Blumberg
Apr 5, 2017·Antimicrobial Agents and Chemotherapy·Russell R KempkerSergo Vashakidze
Jan 20, 2017·The European Respiratory Journal·Ruvandhi R NathavitharanaClaudia M Denkinger
Jun 19, 2019·Open Forum Infectious Diseases·Russell R KempkerNestani Tukvadze
Aug 16, 2017·BMC Infectious Diseases·D M P RamalhoUNKNOWN for Rede-TB Study group
Jul 24, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Sergo A VashakidzeRussell R Kempker

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Methods Mentioned

BETA
light microscopy
Assay

Software Mentioned

REDCap
SAS

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