title: Integrated detection of multi- and extensively drug-resistant tuberculosis using the nitrate reductase assay.
abstract: It currently takes 2-3 months to obtain a diagnosis for multidrug-resistant (MDR-) and extensively drug-resistant tuberculosis (XDR-TB). We evaluated the rapid non-commercial nitrate reductase assay (NRA), which is capable of the simultaneous detection of MDR- and XDR-TB, and  compared the results with the proportion method (PM). The sensitivity was respectively 97%, 99%, 100% and 94.6% for rifampicin (RMP), isoniazid (INH), ofloxacin (OFX) and kanamycin (KM). The specificity was respectively 100%, 95%, 95.7% and 99% for RMP, INH, OFX and KM. The turnaround time  for NRA was 10-14 days, compared to 4-6 weeks for the PM. Our study showed that NRA provided sensitive and specific detection of resistance to first- and second-line drugs.
authors.affiliation: Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Ramos
authors.forename: K
authors.initials: K
authors.lastname: Fissette
authors.forename: P
authors.initials: P
authors.lastname: de Rijk
authors.forename: J C
authors.initials: JC
authors.lastname: Palomino
authors.forename: A
authors.initials: A
authors.lastname: Martin
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D003124:Colorimetry; D004252:DNA Mutational Analysis; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D054908:Extensively Drug-Resistant Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D007612:Kanamycin / Q000627:therapeutic use; D007613:Kanamycin Resistance; D008826:Microbial Sensitivity Tests / Q000379:methods*; D009154:Mutation; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D050901:Nitrate Reductase / Q000032:analysis*; D015242:Ofloxacin / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012293:Rifampin / Q000627:therapeutic use; D012680:Sensitivity and Specificity; D013997:Time Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents; D007612:Kanamycin; D015242:Ofloxacin; D050901:Nitrate Reductase; D007538:Isoniazid; D012293:Rifampin