Performance Comparison of Three Rapid Tests for the Diagnosis of Drug-Resistant Tuberculosis.
Performance Comparison of Three Rapid Tests for the Diagnosis of Drug-Resistant Tuberculosis.
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DOI：
10.1371/journal.pone.0136861
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Eisenach K
中科院分区：
文献类型：
--
作者：
Catanzaro A;Rodwell TC;Catanzaro DG;Garfein RS;Jackson RL;Seifert M;Georghiou SB;Trollip A;Groessl E;Hillery N;Crudu V;Victor TC;Rodrigues C;Lin GS;Valafar F;Desmond E;Eisenach K
这项研究的目的是比较几种最近开发的测定方法，以检测一项大型的跨国现场试验中多种和广泛的耐药性结核病（M/XDR-TB）。
通过线探针测定（LPA），焦磷酸测序（PSQ）和对药物易感性（MODS）的显微镜观察，与BACTEC MGIT960参考标准的M/XDR-TB进行了比较，通过线探针测定（LPA），焦磷酸测序（PSQ）和显微镜观察到了直接从印度TB型clinic cline cline cline and Indorc cline cline cline，对1,128 m/XDR-TB可疑的样本进行了检查。
所有三个测定法的特异性非常出色：Isoniazid（INH），Rifampin（Rif），Moxifloxacin（Mox）和Ofloxacin（Ofx）（OFX）的97-100％和Amikacin（AMK）（AMK），Capreomycin（Capreomycin（Cap）和Kanamycin（Kanamycin（Kanamycin）的良好率）的所有％consitiv and Snectiv。 OFX，AMK和CAP为84-90％，但在统计上，KAN只有48-62％。发现RIF（MOD的表现优于PSQ）和KAN（MODS的表现都超过LPA和PSQ）的电阻才发现显着差异。
所有三个快速的阿萨斯都评估了临床医生对测试的药物的及时检测；在实验室收到样品后，有一天可用的分子结果可获得。成功的结果。
The aim of this study was to compare the performance of several recently developed assays for the detection of multi- and extensively drug-resistant tuberculosis (M/XDR-TB) in a large, multinational field trial. Samples from 1,128 M/XDR-TB suspects were examined by Line Probe Assay (LPA), Pyrosequencing (PSQ), and Microscopic Observation of Drug Susceptibility (MODS) and compared to the BACTEC MGIT960 reference standard to detect M/XDR-TB directly from patient sputum samples collected at TB clinics in India, Moldova, and South Africa. Specificity for all three assays was excellent: 97–100% for isoniazid (INH), rifampin (RIF), moxifloxacin (MOX) and ofloxacin (OFX) and 99–100% for amikacin (AMK), capreomycin (CAP) and kanamycin (KAN) resistance. Sensitivities were lower, but still very good: 94–100% for INH, RIF, MOX and OFX, and 84–90% for AMK and CAP, but only 48–62% for KAN. In terms of agreement, statistically significant differences were only found for detection of RIF (MODS outperformed PSQ) and KAN (MODS outperformed LPA and PSQ) resistance. Mean time-to-result was 1.1 days for LPA and PSQ, 14.3 days for MODS, and 24.7 days for MGIT. All three rapid assays evaluated provide clinicians with timely detection of resistance to the drugs tested; with molecular results available one day following laboratory receipt of samples. In particular, the very high specificity seen for detection of drug resistance means that clinicians can use the results of these rapid tests to avoid the use of toxic drugs to which the infecting organism is resistant and develop treatment regiments that have a higher likelihood of yielding a successful outcome.