title: Detection of resistance to second-line antituberculosis drugs by use of the genotype MTBDRsl assay: a multicenter evaluation and feasibility study.
abstract: The rate of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) has been steadily increasing in countries of the former USSR. The availability of rapid and reliable methods for the detection of drug resistance to second-line drugs is vital for adequate patient management. We evaluated the performance of the Genotype MTBDRsl assay compared to that of phenotypic drug susceptibility testing (Becton Dickinson Bactec MGIT 960 system) with a test panel of 200 Mycobacterium tuberculosis isolates at four sites in Eastern Europe. The interpretability of the Genotype MTBDRsl assay was over 95%. The sensitivity for the detection of resistance to fluoroquinolones, ethambutol, amikacin, and capreomycin varied between 77.3% and 92.3%; however, it was much lower for kanamycin (42.7%). The sensitivity for the detection of XDR TB was 22.6%. The test specificity was over 82% for all drugs. The assay presents a good screening tool for the rapid detection of resistance to individual second-line drugs and can be recommended for use in countries with a high burden of MDR/XDR TB. The sensitivity for the detection of kanamycin resistance needs improvement.
authors.affiliation: Samara Oblast Tuberculosis Dispensary, Samara, Russia.
authors.forename: Olga
authors.initials: O
authors.lastname: Ignatyeva
authors.forename: Irina
authors.initials: I
authors.lastname: Kontsevaya
authors.forename: Alexander
authors.initials: A
authors.lastname: Kovalyov
authors.forename: Yanina
authors.initials: Y
authors.lastname: Balabanova
authors.forename: Vladislav
authors.initials: V
authors.lastname: Nikolayevskyy
authors.forename: Kadri
authors.initials: K
authors.lastname: Toit
authors.forename: Anda
authors.initials: A
authors.lastname: Dragan
authors.forename: Daniela
authors.initials: D
authors.lastname: Maxim
authors.forename: Svetlana
authors.initials: S
authors.lastname: Mironova
authors.forename: Tiina
authors.initials: T
authors.lastname: Kummik
authors.forename: Ionela
authors.initials: I
authors.lastname: Muntean
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Koshkarova
authors.forename: Francis
authors.initials: F
authors.lastname: Drobniewski
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D005061:Europe, Eastern; D005838:Genotype; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D058889:Molecular Typing / Q000379:methods*; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics; D010641:Phenotype; D012680:Sensitivity and Specificity
chemical_list: D000995:Antitubercular Agents