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    Apr 14, 2021
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    Accuracy of molecular drug susceptibility testing amongst tuberculosis patients in Karakalpakstan, Uzbekistan.

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    Authors
    Gil, Horacio
    Margaryan, Hasmik
    Azamat, Ismailov
    Ziba, Bekturdieva
    Bayram, Halmuratov
    Nazirov, Pirimqul
    Gomez, Diana
    Singh, Jatinder
    Zayniddin, Sayfutdinov
    Parpieva, Nargiza
    Achar, Jay
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    Affiliation
    Medecins 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
    Issue Date
    2021-01-06
    
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    Journal
    Tropical Medicine & International Health
    Abstract
    Objectives 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.
    URI
    http://hdl.handle.net/10144/619815
    DOI
    10.1111/tmi.13543
    PubMed ID
    33406316
    Additional Links
    https://doi.org/10.1111/tmi.13543
    Type
    Article
    Language
    en
    EISSN
    1365-3156
    ae974a485f413a2113503eed53cd6c53
    10.1111/tmi.13543
    Scopus Count
    Collections
    TB

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