Accuracy of molecular drug susceptibility testing amongst tuberculosis patients in Karakalpakstan, Uzbekistan.
Authors
Gil, HoracioMargaryan, Hasmik
Azamat, Ismailov
Ziba, Bekturdieva
Bayram, Halmuratov
Nazirov, Pirimqul
Gomez, Diana
Singh, Jatinder
Zayniddin, Sayfutdinov
Parpieva, Nargiza
Achar, Jay
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, SwedenIssue Date
2021-01-06
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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.PubMed ID
33406316Additional Links
https://doi.org/10.1111/tmi.13543Type
ArticleLanguage
enEISSN
1365-3156ae974a485f413a2113503eed53cd6c53
10.1111/tmi.13543
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