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Free Content Evaluation of seven tests for the rapid detection of multidrug-resistant tuberculosis in Uganda

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SETTINGS: National Tuberculosis (TB) Reference Laboratory and Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda.

OBJECTIVE: To evaluate head-to-head rapid tests for drug susceptibility testing (DST) of Mycobacterium tuberculosis against rifampicin (RMP) and isoniazid (INH) in a resource-limited setting.

METHODS: Thirty-one well-characterised strains of M. tuberculosis were tested with the nitrate reductase assay (NRA), microscopic observation drug susceptibility (MODS), MGIT™ 960 (Mycobacterium Growth Indicator Tube 960), Genotype® MTBDRplus, Alamar blue, MTT and resazurin assays. The proportion method on Löwenstein-Jensen medium was used as the reference test.

RESULTS: NRA correctly identified the resistant strains, with 100% sensitivity and specificity. MGIT 960 detected all multidrug-resistant strains but missed one RMP-monoresistant strain. Genotype MTBDRplus detected all RMP-resistant strains, but the sensitivity for detection of INH resistance was lower (88%). Sensitivity and specificity ranged from 86% to 100% for MODS and from 57% to 100% for the Alamar blue, MTT and resazurin assays. Test results were obtained within 2–14 days.

CONCLUSION: In the study setting, NRA, MGIT 960 and Genotype MTBDRplus gave excellent detection of multidrug-resistant tuberculosis, with significantly shorter time to results compared to conventional testing.
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Keywords: M. tuberculosis; MDR-TB; drug susceptibility testing; drug-resistant tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda 2: Department of Bacteriology, Swedish Institute for Infectious Disease Control, Solna, Sweden; and Department of Microbiology, Tumour and Cell Biology, Karolinska Institute, Stockholm, Sweden

Publication date: July 1, 2010

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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 lung health world-wide.

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