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Free Content Multicentre study of nitrate reductase assay for rapid detection of rifampicin-resistant M. tuberculosis

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SETTING: Four regional laboratories belonging to the Mycobacteria Reference Laboratory of São Paulo State, Brazil.

OBJECTIVE: To evaluate the nitrate reductase assay (NRA) for rifampicin (RMP) susceptibility testing of Mycobacterium tuberculosis directly from clinical sputum samples of patients with pulmonary tuberculosis (TB).

DESIGN: Performance of the NRA for detection of M.tuberculosis susceptibility to RMP was evaluated with 210 clinical sputum samples received by the participating laboratories during 2005 and 2006 and compared with the results of the direct proportion method.

RESULTS: Susceptibility tests performed using the NRA and the direct proportion method showed 204 susceptible isolates and six isolates resistant to RMP by both methods. NRA sensitivity and specificity for RMP was 100%. The NRA results of susceptibility tests against RMP were available in 15 days for 87% of the samples. The results showed that NRA may yield a rapid answer in determining resistance for the majority of sputum samples with smear results reported as 3+ and 2+.

CONCLUSION: The results demonstrate the feasibility of NRA for screening resistant strains in sputum samples from patients with pulmonary TB. NRA represents a rapid and low-cost alternative method that might be used in microbiological laboratories where resources are scarce.
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Keywords: Mycobacterium tuberculosis; nitrate reductase; proportion method; susceptibility

Document Type: Regular Paper

Affiliations: 1: Department of Bacteriology, Instituto Adolfo Lutz, Sorocaba, São Paulo, Brazil 2: Department of Bacteriology, Instituto Adolfo Lutz, Santo André, São Paulo, Brazil 3: Department of Bacteriology, Instituto Adolfo Lutz, Campinas, São Paulo, Brazil 4: Department of Bacteriology, Instituto Adolfo Lutz, Ribeirão Preto, São Paulo, Brazil 5: Department of Mycobacteriology, Instituto Adolfo Lutz, São Paulo, Brazil 6: Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium

Publication date: 2009-03-01

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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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