Rapid Detection of Drug Resistant Pulmonary Tuberculosis by Line Probe Assay at a Tertiary Care Centre in North Kerala
Authors/Creators
- 1. Assistant Professor, Department of Microbiology, Govt Medical College, Idukki, Kerala, India
- 2. Associate Professor, Dept of Microbiology, Govt Medical College, Kozhikode, Kerala, India
Description
Background: Early detection of Isoniazid (INH) and rifampicin resistance is essential for treatment and control of multidrug resistant tuberculosis (MDR-TB). Conventional method will take about 8-10 weeks for culture and drug susceptibility tests (DST). MTBDR plus VER 2.0 Line probe assay (LPA) can be used for identification of Mycobacterium tuberculosis complex (MTB complex) and to detect drug resistance of INH and Rifampicin. Materials and Methods: Cross sectional study was conducted in 100 smear positive patients with clinical features of pulmonary tuberculosis. After decontamination and concentration of sputum subjected to LPA and inoculated in parallel to LJ medium. Identification of MTB complex and resistance to INH, rifampicin were detected along with common mutations. Drug susceptibility test from LJ isolates were done by proportional method. Result: Detection rate of MTB complex by LPA in comparison with conventional DST was determined. Sensitivity, specificity, PPV and NPV of LPA was 100%, 97.47%, 77%, 100% for detection of rifampicin mono resistance and 92.86%100%,100%,98.6% for INH mono resistance. Common mutation detected in rpoB gene was S531L.and S315T1 in katG gene. Mean turnaround time for LPA was 3.47 days and for conventional method it was 49.6 days. Conclusion: Direct LPA from smear positive sputum is sensitive and specific diagnostic method for detection of MDR TB along with INH and rifampicin mono resistance. Shorter turnaround time with LPA helps in initiation of treatment earlier and preventing spread of MDR TB.
Abstract (English)
Background: Early detection of Isoniazid (INH) and rifampicin resistance is essential for treatment and control of multidrug resistant tuberculosis (MDR-TB). Conventional method will take about 8-10 weeks for culture and drug susceptibility tests (DST). MTBDR plus VER 2.0 Line probe assay (LPA) can be used for identification of Mycobacterium tuberculosis complex (MTB complex) and to detect drug resistance of INH and Rifampicin. Materials and Methods: Cross sectional study was conducted in 100 smear positive patients with clinical features of pulmonary tuberculosis. After decontamination and concentration of sputum subjected to LPA and inoculated in parallel to LJ medium. Identification of MTB complex and resistance to INH, rifampicin were detected along with common mutations. Drug susceptibility test from LJ isolates were done by proportional method. Result: Detection rate of MTB complex by LPA in comparison with conventional DST was determined. Sensitivity, specificity, PPV and NPV of LPA was 100%, 97.47%, 77%, 100% for detection of rifampicin mono resistance and 92.86%100%,100%,98.6% for INH mono resistance. Common mutation detected in rpoB gene was S531L.and S315T1 in katG gene. Mean turnaround time for LPA was 3.47 days and for conventional method it was 49.6 days. Conclusion: Direct LPA from smear positive sputum is sensitive and specific diagnostic method for detection of MDR TB along with INH and rifampicin mono resistance. Shorter turnaround time with LPA helps in initiation of treatment earlier and preventing spread of MDR TB.
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Additional details
Dates
- Accepted
-
2022-12-11
Software
References
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