title: Drug susceptibility of Mycobacterium tuberculosis to primary antitubercular drugs by nitrate reductase assay.
abstract: OBJECTIVE
  Rapid susceptibility testing of Mycobacterium tuberculosis strains is imperative for therapy selection but traditional drug susceptibility tests take weeks or are expensive. In this study we evaluated nitrate reductase assay which utilizes the detection of nitrate reduction as an indication of growth and therefore results can be obtained faster than by visual detection of colonies.
  
  
  METHODS
  One hundred clinical isolates of M. tuberculosis were tested for four first line antitubercular drugs by nitrate reductase assay (NRA) and were compared with standard proportion method. The bacteria were inoculated on Lowenstein-Jensen (LJ) medium with primary antitubercular drugs and potassium nitrate was incorporated. After incubation for 7- 14 days, nitrate reduction indicating growth could be detected by colour change when reagents were added.
  
  
  RESULTS
  Resistance of isolates as determined by both methods for isoniazid, rifampicin, streptomycin and ethambutol was 32, 35, 62 and 15 per cent respectively. Agreement between NRA and proportion method was 99 per cent for isoniazid and ethambutol. Complete agreement (100%) was found for rifampicin and streptomycin. Results were available in 7-14 days by NRA as compared to proportion method which takes 4-6 wk.
  
  
  CONCLUSIONS
  Nitrate reductase assay is a rapid and inexpensive method for susceptibility testing of M. tuberculosis for primary antitubercular drugs and could be an appropriate alternative to existing methods, particularly in resource-poor settings.
authors.affiliation: Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India. sunilsethi10@hotmail.com
authors.forename: Sunil
authors.initials: S
authors.lastname: Sethi
authors.forename: Sachin
authors.initials: S
authors.lastname: Sharma
authors.forename: S K
authors.initials: SK
authors.lastname: Sharma
authors.forename: S K
authors.initials: SK
authors.lastname: Meharwal
authors.forename: S K
authors.initials: SK
authors.lastname: Jindal
authors.forename: Meera
authors.initials: M
authors.lastname: Sharma
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods*; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000378:metabolism; D050901:Nitrate Reductase; D009565:Nitrate Reductases / Q000378:metabolism; D009566:Nitrates / Q000378:metabolism; D015203:Reproducibility of Results; D014376:Tuberculosis / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents; D009566:Nitrates; D009565:Nitrate Reductases; D050901:Nitrate Reductase