IJCRR - Vol 08 Issue 23, December, 2016
RAPID DETECTION OF MULTI-DRUG RESISTANT TUBERCULOSIS USING DIRECT DRUG SUSCEPTIBILITY TESTING AND LINE PROBE ASSAY
Author: Pranali Medhekar, Nilma Hirani, Sarala Menon, Ameeta Joshi, Abhay Chowdhary
Introduction: Tuberculosis, particularly multi-drug resistant tuberculosis (MDR TB), is a leading cause of morbidity and mortality in developing countries. Conventional methods of DST have a long turnaround time of around 2-3 months. Rapid detection of MDR TB can be achieved by direct tests, liquid based indirect susceptibility tests and molecular line probe assays. This study aims to evaluate the utility of Direct DST and line probe assay (LPA) for rapid detection of MDR TB.
Methodology: A total of 510 sputum concentrates (smear 1+/ more) were subjected to Direct DST and LPA. Conventional DST was put up from the primary cultures of all 510 strains using economic variant of 1% proportion method, considered the gold standard.
Results: Direct DST showed 100% specificity and sensitivity of 98.7%, 97.3% and 97.5% respectively for detection of Isoniazid (INH), Rifampicin (RIF) resistance and for MDR strains. LPA showed specificity of 98.4%, 96.8%, 97% and sensitivity of 97.5%, 98.9% and 98.9% for detection of INH, RIF resistance and MDR strains respectively. The commonest mutation pattern detected in our region was S531L (MUT3) for rpoB gene locus signifying RIF resistance + S315T1 (MUT 1) for katG gene locus signifying high level INH resistance.
Conclusion: Direct DST can be used as a good alternative for rapid detection of MDR-TB in resource poor settings. LPA is definitely a good tool, but requires requisite laboratory infrastructure and trained man-power. From our study, rifampicin resistance can be considered as a surrogate marker of MDR TB.
Keywords: MDR TB, Direct DST, LPA
Pranali Medhekar, Nilma Hirani, Sarala Menon, Ameeta Joshi, Abhay Chowdhary. RAPID DETECTION OF MULTI-DRUG RESISTANT TUBERCULOSIS USING DIRECT DRUG SUSCEPTIBILITY TESTING AND LINE PROBE ASSAY International Journal of Current Research and Review. Vol 08 Issue 23, December, 29-38
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