Authors: Yip, C.W.; Leung, K.L.; Wong, D.; Cheung, D.T.L.; Chu, M.Y.; Tang, H.S.; Kam, K.M.

Source: The International Journal of Tuberculosis and Lung Disease, Volume 10, Number 6, June 2006 , pp. 625-630(6)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

OBJECTIVE: To evaluate the use of denaturation high-performance liquid chromatography (dHPLC) as a rapid method to detect rifampicin (RMP) resistance based on mutations in the rpoB gene in a high-volume laboratory setting.

METHODS: A total of 132 RMP-resistant Mycobacterium tuberculosis strains with different rpoB mutation were used to optimise the running condition of dHPLC as a pilot study. A blind correlation study was subsequently done between dHPLC and in vitro RMP susceptibility tests on 3167 M. tuberculosis strains in a high-throughput clinical setting.

RESULTS: In the pilot study, rpoB mutation could be detected on 116/132 (87.9%) RMP-resistant strains by dHPLC. In the second phase of the study, 84/3107 (2.7%) clinical M. tuberculosis isolates were RMP-resistant. The sensitivity and specificity of dHPLC in the prediction of RMP resistance were 70/84 (83.3%) and 70/77 (91.0%), respectively. The specificity became 100% when 511 Leu to Pro mutation was excluded from the RMP resistance-related genetic changes.

CONCLUSION: In the detection of RMP resistance in a high-throughput laboratory setting, dHPLC has been demonstrated to be rapid, simple, workable, automatable and inexpensive in terms of running costs and the labour involved.

Keywords: tuberculosis; rifampicin; denaturing high performance liquid chromatography; rpoB mutation; drug resistance

Document Type: Regular paper

Affiliations: 1: Department of Health, Tuberculosis Reference Laboratory, Centre for Health Protection, Kowloon, Hong Kong SAR, China

Publication date: 2006-06-01

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• The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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