Role of a GenoType MTBDRplus line probe assay in early detection of multidrug-resistant tuberculosis at a Brazilian reference center.

C S Feliciano, M M P Nascimento, L M P Anselmo, R H C Pocente, F Bellissimo-Rodrigues, V R Bollela
Author Information
  1. C S Feliciano: Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
  2. M M P Nascimento: Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
  3. L M P Anselmo: Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
  4. R H C Pocente: Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
  5. F Bellissimo-Rodrigues: Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
  6. V R Bollela: Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.

Abstract

Resistance to Mycobacterium tuberculosis is a reality worldwide, and its diagnosis continues to be difficult and time consuming. To face this challenge, the World Health Organization has recommended the use of rapid molecular tests. We evaluated the routine use (once a week) of a line probe assay (Genotype MTBDRplus) for early diagnosis of resistance and for assessment of the main related risk factors over 2 years. A total of 170 samples were tested: 15 (8.8%) were resistant, and multidrug resistance was detected in 10 (5.9%). The sensitivity profile took 3 weeks (2 weeks for culture and 1 week for rapid testing). Previous treatment for tuberculosis and the persistence of positive acid-fast smears after 4 months of supervised treatment were the major risk factors observed. The use of molecular tests enabled early diagnosis of drug-resistant bacilli and led to appropriate treatment of the disease. This information has the potential to interrupt the transmission chain of resistant M. tuberculosis.

References

  1. Thorax. 2006 Feb;61(2):158-63 [PMID: 16254056]
  2. J Clin Microbiol. 2007 Aug;45(8):2635-40 [PMID: 17537937]
  3. J Clin Microbiol. 2008 Nov;46(11):3660-7 [PMID: 18784319]
  4. Eur J Clin Microbiol Infect Dis. 2008 Nov;27(11):1079-86 [PMID: 18528720]
  5. PLoS One. 2009;4(5):e5561 [PMID: 19440304]
  6. BMC Infect Dis. 2010;10:41 [PMID: 20187922]
  7. J Bras Pneumol. 2010 Mar-Apr;36(2):157-8 [PMID: 20485934]
  8. Bull World Health Organ. 2012 Feb 1;90(2):111-119D [PMID: 22423162]
  9. Thorax. 2012 Jul;67(7):632-8 [PMID: 22403070]
  10. PLoS One. 2012;7(7):e42479 [PMID: 22848764]
  11. N Engl J Med. 2012 Sep 6;367(10):931-6 [PMID: 22931261]
  12. Mem Inst Oswaldo Cruz. 2012 Sep;107(6):760-6 [PMID: 22990966]
  13. J Bras Pneumol. 2012 Nov-Dec;38(6):733-9 [PMID: 23288118]
  14. BMC Infect Dis. 2012;12:385 [PMID: 23273024]
  15. Clin Infect Dis. 2013 Feb;56(4):503-8 [PMID: 23090928]
  16. Bull World Health Organ. 2013 Jan 1;91(1):36-45 [PMID: 23397349]
  17. PLoS One. 2013;8(9):e72036 [PMID: 24039735]
  18. J Bras Pneumol. 2014 Mar-Apr;40(2):155-63 [PMID: 24831400]
  19. Clin Infect Dis. 2014 Dec 1;59(11):1559-66 [PMID: 25091301]
  20. Braz J Med Biol Res. 1999 Sep;32(9):1073-6 [PMID: 10464381]

MeSH Term

Adult
Antitubercular Agents
Bacteriological Techniques
Brazil
DNA, Bacterial
Early Diagnosis
Female
Genotyping Techniques
Humans
Isoniazid
Male
Microbial Sensitivity Tests
Mycobacterium tuberculosis
Rifampin
Risk Factors
Sensitivity and Specificity
Tuberculosis, Multidrug-Resistant

Chemicals

Antitubercular Agents
DNA, Bacterial
Isoniazid
Rifampin

Word Cloud

Created with Highcharts 10.0.0tuberculosisdiagnosisuseearlytreatmentrapidmoleculartestsweeklineprobeassayMTBDRplusresistanceriskfactors2resistantweeksResistanceMycobacteriumrealityworldwidecontinuesdifficulttimeconsumingfacechallengeWorldHealthOrganizationrecommendedevaluatedroutineGenotypeassessmentmainrelatedyearstotal170samplestested:1588%multidrugdetected1059%sensitivityprofiletook3culture1testingPreviouspersistencepositiveacid-fastsmears4monthssupervisedmajorobservedenableddrug-resistantbacilliledappropriatediseaseinformationpotentialinterrupttransmissionchainMRoleGenoTypedetectionmultidrug-resistantBrazilianreferencecenter

Similar Articles

Cited By