title: Comparison of MGIT 960 & pyrazinamidase activity assay for pyrazinamide susceptibility testing of Mycobacterium tuberculosis.
abstract: OBJECTIVE
  Pyrazinamide is an important front line antimycobacterial drug, which is also being used in the treatment of multi drug resistant tuberculosis along with second line drugs in DOTS plus programme. Conventional testing of pyrazinamide on solid medium is difficult as it is active at acidic pH. Therefore, there is a need for a rapid and simple method for susceptibility testing of pyrazinamide. This study was carried out to compare pyrazinamide susceptibility testing by MGIT 960 and two rapid pyrazinamidase activity tests.
  
  
  METHODS
  Pyrazinamide susceptibility was tested in 136 clinical isolates of Mycobacterium tuberculosis by MGIT 960 and pyrazinamidase activity was tested by classical Wayne's method and modified PZase agar method.
  
  
  RESULTS
  There was 88.9 per cent concordance between MGIT 960 and classical Wayne's method and 93.38 per cent with modified method for pyrazinamidase activity. Using MGIT 960 results as gold standard the sensitivity and specificity of Wayne's method was 88.15 and 90 per cent respectively and that of modified method was 89.4 and 98.3 per cent.
  
  
  CONCLUSIONS
  Our study demonstrates that the modified pyrazinamidase activity test can be used as a screening test to detect resistance to pyrazinamide specially in resource limited settings but confirmation of susceptibility should be done by standard methods like MGIT 960.
authors.affiliation: Department of Microbiology & Immunology, SMS Medical College, Jaipur, India.
authors.forename: Babita
authors.initials: B
authors.lastname: Sharma
authors.forename: Nita
authors.initials: N
authors.lastname: Pal
authors.forename: Bharti
authors.initials: B
authors.lastname: Malhotra
authors.forename: Leela
authors.initials: L
authors.lastname: Vyas
authors.forename: Suman
authors.initials: S
authors.lastname: Rishi
mesh_terms: D000581:Amidohydrolases / Q000378:metabolism*; D000995:Antitubercular Agents / Q000494:pharmacology*; D003470:Culture Media / Q000737:chemistry*; D004352:Drug Resistance, Microbial; D006863:Hydrogen-Ion Concentration; D008826:Microbial Sensitivity Tests / Q000379:methods*; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D011718:Pyrazinamide / Q000494:pharmacology*; D014376:Tuberculosis / Q000382:microbiology*
chemical_list: D000995:Antitubercular Agents; D003470:Culture Media; D011718:Pyrazinamide; D000581:Amidohydrolases; C022490:pyrazinamide deamidase