Accuracy of molecular drug susceptibility testing amongst tuberculosis patients in Karakalpakstan, Uzbekistan.
AffiliationMedecins Sans Frontières (MSF), Nukus, Uzbekistan; Republican TB No 1 Hospital Laboratory of Karakalpakstan, Nukus, Uzbekistan; Republican TB No 1 Hospital of Karakalpakstan, Nukus, Uzbekistan; MSF, Amsterdam, Holland; MSF, Tashkent, Uzbekistan; Tuberculosis Institute, Tashkent, Uzbekistan; National Tuberculosis Reference Laboratory, Tashkent, Uzbekistan; MSF, London, UK9Karolinska Institutet, Stockholm, Sweden
MetadataShow full item record
AbstractObjectives 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. Methods A total of 6,670 specimens received in the Republican TB No 1 Hospital Laboratory of Karakalpakstan between January and July 2017 from new and retreatment patients were analyzed. 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. Results 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%). Conclusions 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 suggests that resistance mutations circulating in the Republic of Karakalpakstan for other drugs were not detected by the methods used here. This merits further investigation.
- Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults.
- Authors: Steingart KR, Schiller I, Horne DJ, Pai M, Boehme CC, Dendukuri N
- Issue date: 2014 Jan 21
- The diagnostic accuracy of the GenoType(®) MTBDRsl assay for the detection of resistance to second-line anti-tuberculosis drugs.
- Authors: Theron G, Peter J, Richardson M, Barnard M, Donegan S, Warren R, Steingart KR, Dheda K
- Issue date: 2014 Oct 29
- Xpert MTB/RIF for rapid detection of rifampicin-resistant Mycobacterium tuberculosis from pulmonary tuberculosis patients in Southwest Ethiopia.
- Authors: Tadesse M, Aragaw D, Dimah B, Efa F, Abebe G
- Issue date: 2016 Dec
- Xpert<sup>®</sup> MTB/RIF assay for extrapulmonary tuberculosis and rifampicin resistance.
- Authors: Kohli M, Schiller I, Dendukuri N, Dheda K, Denkinger CM, Schumacher SG, Steingart KR
- Issue date: 2018 Aug 27
- Xpert Ultra versus Xpert MTB/RIF for pulmonary tuberculosis and rifampicin resistance in adults with presumptive pulmonary tuberculosis.
- Authors: Zifodya JS, Kreniske JS, Schiller I, Kohli M, Dendukuri N, Schumacher SG, Ochodo EA, Haraka F, Zwerling AA, Pai M, Steingart KR, Horne DJ
- Issue date: 2021 Feb 22