E-test for susceptibility testing of Mycobacterium tuberculosis.
METHODS
Initial isolates should be tested for drug susceptibility to confirm the anticipated effectiveness of chemotherapy.


OBJECTIVE
To evaluate E-test strips for susceptibility testing of Mycobacterium tuberculosis.


METHODS
A proportion method using Lowenstein-Jensen medium and the Bactec radiometric system were compared with the E-test (isoniazid [INH], rifampicin [RMP], ethambutol [EMB] and streptomycin [SM]).


RESULTS
For 73 of the 81 M. tuberculosis isolates (90.1%) the proportion and E-test methods yielded concordant susceptibility results against all four antimicrobial agents tested. Of these 73 strains, 69 were fully susceptible; the four isolates showing resistance to antimicrobial drugs by both methods were also resistant when tested by Bactec 460TB. While the proportion method indicated susceptibility for the eight remaining strains, E-test results showed mono EMB resistance in five strains, INH resistance for two isolates (including one isolate resistant to EMB plus INH), and for one strain E-test yielded resistance to EMB and SM. Using Bactec as the reference method, the E-test resulted in false resistance in eight strains and no false susceptibility.


CONCLUSIONS
Due to a substantial rate of false resistance, this method cannot be recommended at present for practical use in clinical laboratories.
Hausdorfer
J
J
Institute of Hygiene, University of Innsbruck, Austria.
Sompek
E
E
Allerberger
F
F
Dierich
M P
MP
Rüsch-Gerdes
S
S
D005188:False Negative Reactions; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000295:instrumentation / Q000379:methods*; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects*