The diagnostic accuracy of the MTBDRplus and MTBDRsl assays for drug-resistant TB detection when performed on sputum and culture isolates

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dc.contributor.authorTomasicchio, Micheleen_ZA
dc.contributor.authorTheron, Granten_ZA
dc.contributor.authorPietersen, Elizeen_ZA
dc.contributor.authorStreicher, Elizabeth M.en_ZA
dc.contributor.authorStanley-Josephs, Danielleen_ZA
dc.contributor.authorVan Helden, Paulen_ZA
dc.contributor.authorWarren, Roben_ZA
dc.contributor.authorDheda, Keertanen_ZA
dc.date.accessioned2017-10-23T10:15:36Z
dc.date.available2017-10-23T10:15:36Z
dc.date.issued2016
dc.descriptionCITATION: Tomasicchio, M., et al. 2016. The diagnostic accuracy of the MTBDRplus and MTBDRsl assays for drug-resistant TB detection when performed on sputum and culture isolates. Scientific Reports 6:17850, doi:10.1038/srep17850.en_ZA
dc.descriptionThe original publication is available at http://www.nature.com/srepen_ZA
dc.description.abstractAlthough molecular tests for drug-resistant TB perform well on culture isolates, their accuracy using clinical samples, particularly from TB and HIV-endemic settings, requires clarification. The MTBDRplus and MTBDRsl line probe assays were evaluated in 181 sputum samples and 270 isolates from patients with culture-confirmed drug-sensitive-TB, MDR-TB, or XDR-TB. Phenotypic culture-based testing was the reference standard. Using sputum, the sensitivities for resistance was 97.7%, 95.4%, 58.9%, 61.6% for rifampicin, isoniazid, ofloxacin, and amikacin, respectively, whereas the specificities were 91.8%, 89%, 100%, and 100%, respectively. MTBDRsl sensitivity differed in smear-positive vs. smear-negative samples (79.2% vs. 20%, pā€‰<ā€‰0.0001 for ofloxacin; 72.9% vs. 37%, pā€‰=ā€‰0.0023 for amikacin) but not by HIV status. If used sequentially, MTBDRplus and MTBDRsl could rule-in XDR-TB in 78.5% (22/28) and 10.5% (2/19) of smear-positive and smear-negative samples, respectively. On culture isolates, the sensitivity for resistance to rifampicin, isoniazid, ofloxacin, and amikacin was 95.1%, 96.1%, 72.3% and 76.6%, respectively, whereas the specificities exceeded 96%. Using a sequential testing approach, rapid sputum-based diagnosis of fluoroquinolone or aminoglycoside-resistant TB is feasible only in smear-positive samples, where rule-in value is good. Further investigation is required in samples that test susceptible in order to rule-out second-line drug resistance.en_ZA
dc.description.urihttps://www.nature.com/articles/srep17850
dc.description.versionPublisher's version
dc.format.extent8 pages : illustrationsen_ZA
dc.identifier.citationTomasicchio, M., et al. 2016. The diagnostic accuracy of the MTBDRplus and MTBDRsl assays for drug-resistant TB detection when performed on sputum and culture isolates. Scientific Reports 6:17850, doi:10.1038/srep17850en_ZA
dc.identifier.issn2045-2322 (online)
dc.identifier.otherdoi:10.1038/srep17850
dc.identifier.urihttp://hdl.handle.net/10019.1/102368
dc.language.isoen_ZAen_ZA
dc.publisherSpringer Natureen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectTuberculosis -- Sputum -- Examinationen_ZA
dc.subjectTuberculosis -- Diagnosisen_ZA
dc.subjectMultidrug-resistant tuberculosisen_ZA
dc.subjectTuberculosis -- Isolated culture sampleen_ZA
dc.titleThe diagnostic accuracy of the MTBDRplus and MTBDRsl assays for drug-resistant TB detection when performed on sputum and culture isolatesen_ZA
dc.typeArticleen_ZA
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