Accuracy of molecular drug susceptibility testing amongst tuberculosis patients in Karakalpakstan, Uzbekistan.
Antibiotics, Antitubercular
/ therapeutic use
Capreomycin
/ therapeutic use
Drug Resistance, Bacterial
Fluoroquinolones
/ therapeutic use
Humans
Isoniazid
/ therapeutic use
Kanamycin
/ therapeutic use
Microbial Sensitivity Tests
/ methods
Mutation
Mycobacterium tuberculosis
/ genetics
Polymerase Chain Reaction
Reproducibility of Results
Retrospective Studies
Rifampin
/ therapeutic use
Tuberculosis
/ drug therapy
Tuberculosis, Multidrug-Resistant
/ drug therapy
Tuberculosis, Pulmonary
/ drug therapy
Uzbekistan
GeneXpert
Mycobacteria
diagnostic accuracy
drug susceptibility testing
drug-resistant tuberculosis
line probe assay
Journal
Tropical medicine & international health : TM & IH
ISSN: 1365-3156
Titre abrégé: Trop Med Int Health
Pays: England
ID NLM: 9610576
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
pubmed:
7
1
2021
medline:
31
7
2021
entrez:
6
1
2021
Statut:
ppublish
Résumé
In this retrospective study, we evaluated the diagnostic accuracy of molecular tests (MT) for the detection of DR-TB, compared to the gold standard liquid-based drug susceptibility testing (DST) in Karakalpakstan. A total of 6670 specimens received in the Republican TB No 1 Hospital Laboratory of Karakalpakstan between January and July 2017 from new and retreatment patients were analysed. Samples were tested using Xpert MTB/RIF and line probe assays (LPA) for the detection of mutations associated with resistance. The sensitivity and specificity of MTs were calculated relative to results based on DST. The accuracy of MT for detection of rifampicin resistance was high, with sensitivity and specificity over 98%. However, we observed reduced sensitivity of LPA for detection of resistance; 86% for isoniazid (95% CI 82-90%), 86% for fluoroquinolones (95% CI 68-96%), 70% for capreomycin (95% CI 46-88%) and 23% for kanamycin (95% CI 13-35%). We show that MTs are a useful tool for rapid and safe diagnosis of DR-TB; however, clinicians should be aware of their limitations. Although detection of rifampicin resistance was highly accurate, our data suggest that resistance mutations circulating in the Republic of Karakalpakstan for other drugs were not detected by the methods used here. This merits further investigation.
Substances chimiques
Antibiotics, Antitubercular
0
Fluoroquinolones
0
Capreomycin
11003-38-6
Kanamycin
59-01-8
Isoniazid
V83O1VOZ8L
Rifampin
VJT6J7R4TR
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Validation Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
421-427Informations de copyright
© 2021 John Wiley & Sons Ltd.
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