BACKGROUND: The GenoType® MTBDRsl assay is a new rapid assay for the detection of resistance to second-line anti-tuberculosis drugs. OBJECTIVE: To evaluate the MTBDRsl assay on 342 multidrug-resistant tuberculosis isolates for resistance to ofloxacin (OFX), kanamycin (KM), capreomycin (CPM) and ethambutol (EMB), to compare the results to the agar proportion method, and to test discrepant results using DNA sequencing. RESULT: The sensitivity and specificity of the MTBDRsl assay were respectively 70.3% and 97.7% for OFX, 25.0% and 98.7% for KM, 21.2% and 98.7% for CPM and 56.3% and 56.0% for EMB. DNA sequencing identified mutations that were not detected by the MTBDRsl assay. The 8/11 phenotypically OFX-resistant isolates had mutations in gyrA (2/8 had an additional mutation in the gyrB gene), 1/11 had mutations only in the gyrB gene, 6/21 phenotypically KM-resistant isolates had mutations in the rrs gene, and 7/26 and 20/26 phenotypically CPM-resistant isolates had mutations in the rrs and tlyA genes. CONCLUSION: The MTBDRsl assay showed lower sensitivity than previous studies. The assay performed favourably for OFX; however, it was less sensitive in the detection of KM/CPM resistance and demonstrated low sensitivity and specificity for EMB resistance. It is recommended that the MTBDRsl assay include additional genes to achieve better sensitivity for all the drugs tested.
BACKGROUND: The GenoType® MTBDRsl assay is a new rapid assay for the detection of resistance to second-line anti-tuberculosis drugs. OBJECTIVE: To evaluate the MTBDRsl assay on 342 multidrug-resistant tuberculosis isolates for resistance to ofloxacin (OFX), kanamycin (KM), capreomycin (CPM) and ethambutol (EMB), to compare the results to the agar proportion method, and to test discrepant results using DNA sequencing. RESULT: The sensitivity and specificity of the MTBDRsl assay were respectively 70.3% and 97.7% for OFX, 25.0% and 98.7% for KM, 21.2% and 98.7% for CPM and 56.3% and 56.0% for EMB. DNA sequencing identified mutations that were not detected by the MTBDRsl assay. The 8/11 phenotypically OFX-resistant isolates had mutations in gyrA (2/8 had an additional mutation in the gyrB gene), 1/11 had mutations only in the gyrB gene, 6/21 phenotypically KM-resistant isolates had mutations in the rrs gene, and 7/26 and 20/26 phenotypically CPM-resistant isolates had mutations in the rrs and tlyA genes. CONCLUSION: The MTBDRsl assay showed lower sensitivity than previous studies. The assay performed favourably for OFX; however, it was less sensitive in the detection of KM/CPM resistance and demonstrated low sensitivity and specificity for EMB resistance. It is recommended that the MTBDRsl assay include additional genes to achieve better sensitivity for all the drugs tested.
Authors: Hanna Nebenzahl-Guimaraes; Karen R Jacobson; Maha R Farhat; Megan B Murray Journal: J Antimicrob Chemother Date: 2013-09-20 Impact factor: 5.790
Authors: Yingda L Xie; Soumitesh Chakravorty; Derek T Armstrong; Sandra L Hall; Laura E Via; Taeksun Song; Xing Yuan; Xiaoying Mo; Hong Zhu; Peng Xu; Qian Gao; Myungsun Lee; Jongseok Lee; Laura E Smith; Ray Y Chen; Joon Sung Joh; YoungSoo Cho; Xin Liu; Xianglin Ruan; Lili Liang; Nila Dharan; Sang-Nae Cho; Clifton E Barry; Jerrold J Ellner; Susan E Dorman; David Alland Journal: N Engl J Med Date: 2017-09-14 Impact factor: 91.245
Authors: Claudia M Denkinger; David Dolinger; Marco Schito; William Wells; Frank Cobelens; Madhukar Pai; Matteo Zignol; Daniela Maria Cirillo; David Alland; Martina Casenghi; Jim Gallarda; Catharina C Boehme; Mark D Perkins Journal: J Infect Dis Date: 2015-04-01 Impact factor: 5.226