Rapid screening of MDR-TB using molecular Line Probe Assay is feasible in Uganda.
Rapid screening of MDR-TB using molecular Line Probe Assay is feasible in Uganda.
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DOI：
10.1186/1471-2334-10-41
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发表时间：
2010-02-26
影响因子：
3.7
通讯作者：
O'Brien R
中科院分区：
文献类型：
--
作者：
Albert H;Bwanga F;Mukkada S;Nyesiga B;Ademun JP;Lukyamuzi G;Haile M;Hoffner S;Joloba M;O'Brien R
据估计，乌干达每年约有500例新的涂片阳性耐多药结核病病例。2008年在坎帕拉，报告的耐多药结核病流行率在新的和以前接受过治疗的结核病病例中分别为1.0%和12.3%。线探针检测（LPAs）最近已被批准用于低收入环境，可用于在1-2天内筛查痰涂片阳性痰标本对利福平和异烟肼的耐药性。我们评估了商业线性探针检测试剂盒（基因型MTBDRplus）的性能，用于直接快速检测来自乌干达坎帕拉参考实验室的118例既往接受过治疗的结核病患者的涂阳痰标本中的利福平和异烟肼耐药性。结果与MGIT 960液体培养和药敏试验（DST）进行比较。LPA测试也在大学实验室平行进行，以评估结果的再现性。总体而言，95.8%的涂片阳性标本使用LPA在1-2天内给出了可解释的结果。检测利福平耐药的敏感性、特异性、阳性预测值和阴性预测值分别为100.0%、96.1%、83.3%和100.0%，检测异烟肼耐药的敏感性、特异性、阳性预测值和阴性预测值分别为80.8%、100.0%、100.0%和93.0%;耐药率分别为92.3%、96.2%、80.0%和98.7%。LPA结果的重现性非常高，两个实验室之间的结果一致性为98.1%。LPA是乌干达快速筛查耐多药结核病的适当工具，并有可能大大缩短DST结果的周转时间。必须认真注意培训、监督和遵守严格的实验室协议，以确保在常规实施过程中获得高质量的结果。
About 500 new smear-positive Multidrug-resistant tuberculosis (MDR-TB) cases are estimated to occur per year in Uganda. In 2008 in Kampala, MDR-TB prevalence was reported as 1.0% and 12.3% in new and previously treated TB cases respectively. Line probe assays (LPAs) have been recently approved for use in low income settings and can be used to screen smear-positive sputum specimens for resistance to rifampicin and isoniazid in 1-2 days. We assessed the performance of a commercial line probe assay (Genotype MTBDRplus) for rapid detection of rifampicin and isoniazid resistance directly on smear-positive sputum specimens from 118 previously treated TB patients in a reference laboratory in Kampala, Uganda. Results were compared with MGIT 960 liquid culture and drug susceptibility testing (DST). LPA testing was also performed in parallel in a University laboratory to assess the reproducibility of results. Overall, 95.8% of smear-positive specimens gave interpretable results within 1-2 days using LPA. Sensitivity, specificity, positive and negative predictive values were 100.0%, 96.1%, 83.3% and 100.0% for detection of rifampicin resistance; 80.8%, 100.0%, 100.0% and 93.0% for detection of isoniazid resistance; and 92.3%, 96.2%, 80.0% and 98.7% for detection of multidrug-resistance compared with conventional results. Reproducibility of LPA results was very high with 98.1% concordance of results between the two laboratories. LPA is an appropriate tool for rapid screening for MDR-TB in Uganda and has the potential to substantially reduce the turnaround time of DST results. Careful attention must be paid to training, supervision and adherence to stringent laboratory protocols to ensure high quality results during routine implementation.
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影响因子：
168.9
作者：
TELENTI, A;IMBODEN, P;BODMER, T
通讯作者：
BODMER, T
影响因子：
4.9
作者：
Mokrousov, I;Narvskaya, O;Vyshnevskiy, B
通讯作者：
Vyshnevskiy, B
DOI：
10.1164/rccm.200709-1436oc
发表时间：
2008-04-01
影响因子：
24.7
作者：
Barnard, Marinus;Allbert, Heidi;Bosiman, Marlein E.
通讯作者：
Bosiman, Marlein E.
影响因子：
168.9
作者：
Behr, MA;Warren, SA;Small, PM
通讯作者：
Small, PM
影响因子：
4.9
作者：
Baker, LV;Brown, TJ;Drobniewski, FA
通讯作者：
Drobniewski, FA