Evaluation of seven tests for the rapid detection of multidrug-resistant tuberculosis in 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.
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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