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Role of a GenoType MTBDRplus line probe assay in early detection of multidrug-resistant tuberculosis at a Brazilian reference center.

Feliciano CS, Nascimento MM, Anselmo LM, Pocente RH, Bellissimo-Rodrigues F, Bollela VR - Braz. J. Med. Biol. Res. (2015)

Bottom Line: To face this challenge, the World Health Organization has recommended the use of rapid molecular tests.A total of 170 samples were tested: 15 (8.8%) were resistant, and multidrug resistance was detected in 10 (5.9%).The sensitivity profile took 3 weeks (2 weeks for culture and 1 week for rapid testing).

View Article: PubMed Central - PubMed

Affiliation: Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.

ABSTRACT
Resistance to Mycobacterium tuberculosis is a reality worldwide, and its diagnosis continues to be difficult and time consuming. To face this challenge, the World Health Organization has recommended the use of rapid molecular tests. We evaluated the routine use (once a week) of a line probe assay (Genotype MTBDRplus) for early diagnosis of resistance and for assessment of the main related risk factors over 2 years. A total of 170 samples were tested: 15 (8.8%) were resistant, and multidrug resistance was detected in 10 (5.9%). The sensitivity profile took 3 weeks (2 weeks for culture and 1 week for rapid testing). Previous treatment for tuberculosis and the persistence of positive acid-fast smears after 4 months of supervised treatment were the major risk factors observed. The use of molecular tests enabled early diagnosis of drug-resistant bacilli and led to appropriate treatment of the disease. This information has the potential to interrupt the transmission chain of resistant M. tuberculosis.

No MeSH data available.


Related in: MedlinePlus

Schematic representation of the Genotype MTBDRplus resultsin isolates resistant to rifampicin and/or isoniazid.
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f01: Schematic representation of the Genotype MTBDRplus resultsin isolates resistant to rifampicin and/or isoniazid.

Mentions: From 12 samples that exhibited resistance to rifampicin by the molecular testGenotype MTBDRplus, 9 (75%) showed the same genotypic profile ofresistance, i.e., loss of the wild-type band WT8 and appearance of the MUT3 band ofthe rpoB gene, which infers the mutation S531L. The genotypicprofile of resistance to isoniazid appeared to be very heterogeneous in this sample:five isolates had a high-level resistance profile to the drug (loss of wild-type bandand appearance of the band referring to MUT1 of the KatG gene, whichinfers the mutation S315T1); and the other five isolates showed a low-levelresistance pattern. Of those, one showed a loss of the WT2 wild-type band and fourshowed a loss of WT1 and presence of the band referring to MUT1 of theinhA regulatory region, which infers the mutation C15T (Figure 1).


Role of a GenoType MTBDRplus line probe assay in early detection of multidrug-resistant tuberculosis at a Brazilian reference center.

Feliciano CS, Nascimento MM, Anselmo LM, Pocente RH, Bellissimo-Rodrigues F, Bollela VR - Braz. J. Med. Biol. Res. (2015)

Schematic representation of the Genotype MTBDRplus resultsin isolates resistant to rifampicin and/or isoniazid.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4541697&req=5

f01: Schematic representation of the Genotype MTBDRplus resultsin isolates resistant to rifampicin and/or isoniazid.
Mentions: From 12 samples that exhibited resistance to rifampicin by the molecular testGenotype MTBDRplus, 9 (75%) showed the same genotypic profile ofresistance, i.e., loss of the wild-type band WT8 and appearance of the MUT3 band ofthe rpoB gene, which infers the mutation S531L. The genotypicprofile of resistance to isoniazid appeared to be very heterogeneous in this sample:five isolates had a high-level resistance profile to the drug (loss of wild-type bandand appearance of the band referring to MUT1 of the KatG gene, whichinfers the mutation S315T1); and the other five isolates showed a low-levelresistance pattern. Of those, one showed a loss of the WT2 wild-type band and fourshowed a loss of WT1 and presence of the band referring to MUT1 of theinhA regulatory region, which infers the mutation C15T (Figure 1).

Bottom Line: To face this challenge, the World Health Organization has recommended the use of rapid molecular tests.A total of 170 samples were tested: 15 (8.8%) were resistant, and multidrug resistance was detected in 10 (5.9%).The sensitivity profile took 3 weeks (2 weeks for culture and 1 week for rapid testing).

View Article: PubMed Central - PubMed

Affiliation: Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.

ABSTRACT
Resistance to Mycobacterium tuberculosis is a reality worldwide, and its diagnosis continues to be difficult and time consuming. To face this challenge, the World Health Organization has recommended the use of rapid molecular tests. We evaluated the routine use (once a week) of a line probe assay (Genotype MTBDRplus) for early diagnosis of resistance and for assessment of the main related risk factors over 2 years. A total of 170 samples were tested: 15 (8.8%) were resistant, and multidrug resistance was detected in 10 (5.9%). The sensitivity profile took 3 weeks (2 weeks for culture and 1 week for rapid testing). Previous treatment for tuberculosis and the persistence of positive acid-fast smears after 4 months of supervised treatment were the major risk factors observed. The use of molecular tests enabled early diagnosis of drug-resistant bacilli and led to appropriate treatment of the disease. This information has the potential to interrupt the transmission chain of resistant M. tuberculosis.

No MeSH data available.


Related in: MedlinePlus