Combination of commercially available molecular assays and culture based methods in diagnosis of tuberculosis and drug resistant tuberculosis
ABSTRACT Early diagnosis of tuberculosis is of major clinical importance. Among 4733 clinical specimens collected from 3363 patients and subjected to Ziehl-Neelsen microscopy, 4109 were inoculated onto Löwenstein-Jensen slants and 3139 in Bactec/9000MB. Polymerase Chain Reaction (PCR) was performed in 3139 specimens, whereas, a genotypic assay was directly applied in 93 Mycobacterium tuberculosis complex PCR-positive for isoniazid and rifampicin resistance detection specimens (GenoType MTBDRplus). Recovered M. tuberculosis isolates (64) as well as, 21 more sent from Regional Hospitals were tested for antimycobacterial resistance with a phenotypic (manual MGIT-SIRE) and a genotypic assay (GenoType MTBDRplus). PCR in the clinical specimens showed excellent specificity (97.4%) and accuracy (96.8%), good sensitivity (70.4%), but low positive predictive value (40.3%). MGIT-SIRE performed to M. tuberculosis did not confer a reliable result in 16 isolates. Of the remaining 69 isolates, 15 were resistant to streptomycin, seven to isoniazid, seven to ethambutol and five to rifampicin. GenoType MTBDRplus correctly detected isoniazid (seven) and rifampicin-resistant M. tuberculosis strains (five), showing an excellent performance overall (100%). Susceptibility results by the molecular assay applied directly to clinical specimens were identical to those obtained from recovered isolates of the corresponding patients. Combining molecular and conventional methods greatly contribute to early diagnosis and accurate susceptibility testing of tuberculosis.
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Sociedade Brasileira de Microbiologia
2017
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oai:scielo:S1517-838220170004007852017-10-31Combination of commercially available molecular assays and culture based methods in diagnosis of tuberculosis and drug resistant tuberculosisGkaravela,LampriniPapadimitriou-Olivgeris,MatthaiosFoka,AntigoniKolonitsiou,FevroniaSpiliopoulou,AnastasiaCharokopos,NikolaosVoulgaridis,ApostolosTsiamita,MariaMarangos,MarkosAnastassiou,Evangelos D.Spiliopoulou,Iris Mycobacterium tuberculosis PCR GenoType MTBDRplus ABSTRACT Early diagnosis of tuberculosis is of major clinical importance. Among 4733 clinical specimens collected from 3363 patients and subjected to Ziehl-Neelsen microscopy, 4109 were inoculated onto Löwenstein-Jensen slants and 3139 in Bactec/9000MB. Polymerase Chain Reaction (PCR) was performed in 3139 specimens, whereas, a genotypic assay was directly applied in 93 Mycobacterium tuberculosis complex PCR-positive for isoniazid and rifampicin resistance detection specimens (GenoType MTBDRplus). Recovered M. tuberculosis isolates (64) as well as, 21 more sent from Regional Hospitals were tested for antimycobacterial resistance with a phenotypic (manual MGIT-SIRE) and a genotypic assay (GenoType MTBDRplus). PCR in the clinical specimens showed excellent specificity (97.4%) and accuracy (96.8%), good sensitivity (70.4%), but low positive predictive value (40.3%). MGIT-SIRE performed to M. tuberculosis did not confer a reliable result in 16 isolates. Of the remaining 69 isolates, 15 were resistant to streptomycin, seven to isoniazid, seven to ethambutol and five to rifampicin. GenoType MTBDRplus correctly detected isoniazid (seven) and rifampicin-resistant M. tuberculosis strains (five), showing an excellent performance overall (100%). Susceptibility results by the molecular assay applied directly to clinical specimens were identical to those obtained from recovered isolates of the corresponding patients. Combining molecular and conventional methods greatly contribute to early diagnosis and accurate susceptibility testing of tuberculosis.info:eu-repo/semantics/openAccessSociedade Brasileira de MicrobiologiaBrazilian Journal of Microbiology v.48 n.4 20172017-12-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1517-83822017000400785en10.1016/j.bjm.2017.04.001 |
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Gkaravela,Lamprini Papadimitriou-Olivgeris,Matthaios Foka,Antigoni Kolonitsiou,Fevronia Spiliopoulou,Anastasia Charokopos,Nikolaos Voulgaridis,Apostolos Tsiamita,Maria Marangos,Markos Anastassiou,Evangelos D. Spiliopoulou,Iris |
| spellingShingle |
Gkaravela,Lamprini Papadimitriou-Olivgeris,Matthaios Foka,Antigoni Kolonitsiou,Fevronia Spiliopoulou,Anastasia Charokopos,Nikolaos Voulgaridis,Apostolos Tsiamita,Maria Marangos,Markos Anastassiou,Evangelos D. Spiliopoulou,Iris Combination of commercially available molecular assays and culture based methods in diagnosis of tuberculosis and drug resistant tuberculosis |
| author_facet |
Gkaravela,Lamprini Papadimitriou-Olivgeris,Matthaios Foka,Antigoni Kolonitsiou,Fevronia Spiliopoulou,Anastasia Charokopos,Nikolaos Voulgaridis,Apostolos Tsiamita,Maria Marangos,Markos Anastassiou,Evangelos D. Spiliopoulou,Iris |
| author_sort |
Gkaravela,Lamprini |
| title |
Combination of commercially available molecular assays and culture based methods in diagnosis of tuberculosis and drug resistant tuberculosis |
| title_short |
Combination of commercially available molecular assays and culture based methods in diagnosis of tuberculosis and drug resistant tuberculosis |
| title_full |
Combination of commercially available molecular assays and culture based methods in diagnosis of tuberculosis and drug resistant tuberculosis |
| title_fullStr |
Combination of commercially available molecular assays and culture based methods in diagnosis of tuberculosis and drug resistant tuberculosis |
| title_full_unstemmed |
Combination of commercially available molecular assays and culture based methods in diagnosis of tuberculosis and drug resistant tuberculosis |
| title_sort |
combination of commercially available molecular assays and culture based methods in diagnosis of tuberculosis and drug resistant tuberculosis |
| description |
ABSTRACT Early diagnosis of tuberculosis is of major clinical importance. Among 4733 clinical specimens collected from 3363 patients and subjected to Ziehl-Neelsen microscopy, 4109 were inoculated onto Löwenstein-Jensen slants and 3139 in Bactec/9000MB. Polymerase Chain Reaction (PCR) was performed in 3139 specimens, whereas, a genotypic assay was directly applied in 93 Mycobacterium tuberculosis complex PCR-positive for isoniazid and rifampicin resistance detection specimens (GenoType MTBDRplus). Recovered M. tuberculosis isolates (64) as well as, 21 more sent from Regional Hospitals were tested for antimycobacterial resistance with a phenotypic (manual MGIT-SIRE) and a genotypic assay (GenoType MTBDRplus). PCR in the clinical specimens showed excellent specificity (97.4%) and accuracy (96.8%), good sensitivity (70.4%), but low positive predictive value (40.3%). MGIT-SIRE performed to M. tuberculosis did not confer a reliable result in 16 isolates. Of the remaining 69 isolates, 15 were resistant to streptomycin, seven to isoniazid, seven to ethambutol and five to rifampicin. GenoType MTBDRplus correctly detected isoniazid (seven) and rifampicin-resistant M. tuberculosis strains (five), showing an excellent performance overall (100%). Susceptibility results by the molecular assay applied directly to clinical specimens were identical to those obtained from recovered isolates of the corresponding patients. Combining molecular and conventional methods greatly contribute to early diagnosis and accurate susceptibility testing of tuberculosis. |
| publisher |
Sociedade Brasileira de Microbiologia |
| publishDate |
2017 |
| url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1517-83822017000400785 |
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