title: Mycobacterium tuberculosis and rifampin resistance, United Kingdom.
abstract: The United Kingdom Health Protection Agency Mycobacterium Reference Unit offers a national "Fastrack" molecular service for detecting Mycobacterium tuberculosis complex (MTBC) and rifampin resistance by using the INNO-LiPA Rif.TB assay. We analyzed the service in a routine, nontrial context of 1,997 primary clinical specimens, including 658 nonrespiratory specimens. The overall adjusted concordance, sensitivity, specificity, positive predictive value, and negative predictive value for detecting MTBC were 91.2%, 85.2%, 96.2%, 95.7%, and 86.7%, respectively (unadjusted, 86.7%, 85.2%, 88.2%, 86.9%, and 86.7%), when false-positive samples from patients (n = 83) with a known microbiologic diagnosis of MTBC or patients receiving current or recent antituberculous treatment were excluded. The parameters for detecting rifampin resistance were 99.1%, 95.0%, 99.6%, 92.7%, and 99.7%, respectively. The assay enabled earlier diagnosis of MTBC and rifampin resistance (15.2 days) compared with culture-based techniques (30.7 days).
authors.affiliation: Health Protection Agency, National Mycobacterium Reference Unit, Institute of Cell and Molecular Science, Barts and the London School of Medicine, 2 Newark Street, London, United Kingdom.
authors.forename: I-Ching
authors.initials: IC
authors.lastname: Sam
authors.forename: Francis
authors.initials: F
authors.lastname: Drobniewski
authors.forename: Philip
authors.initials: P
authors.lastname: More
authors.forename: Melanie
authors.initials: M
authors.lastname: Kemp
authors.forename: Timothy
authors.initials: T
authors.lastname: Brown
mesh_terms: D000904:Antibiotics, Antitubercular / Q000494:pharmacology / Q000627:therapeutic use*; D015373:Bacterial Typing Techniques; D024881:Drug Resistance, Bacterial; D006801:Humans; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D011237:Predictive Value of Tests; D011933:Reagent Kits, Diagnostic / Q000592:standards*; D012293:Rifampin / Q000494:pharmacology / Q000627:therapeutic use*; D012680:Sensitivity and Specificity; D013997:Time Factors; D014376:Tuberculosis / Q000188:drug therapy* / Q000382:microbiology; D006113:United Kingdom
chemical_list: D000904:Antibiotics, Antitubercular; D011933:Reagent Kits, Diagnostic; D012293:Rifampin