title: Microscopic observation drug susceptibility assay in the diagnosis of multidrug-resistant tuberculosis.
abstract: BACKGROUND
  Early detection of multidrug-resistant Mycobacterium tuberculosis (MDR-TB) is of primary importance for both patient management and infection control. Optimal methods for identifying MDR-TB in a timely and affordable manner in resource-limited settings are not yet available.
  
  
  OBJECTIVE
  To evaluate the performance of a low-technology but rapid drug susceptibility testing method, the microscopic observation drug susceptibility assay (MODS), in the concurrent detection of M. tuberculosis and its susceptibility to isoniazid (INH) and rifampin (RMP) directly from sputum specimens.
  
  
  METHODS
  A total of 115 smear-positive TB patients admitted to Abbasia Chest Hospital, Cairo, Egypt, were simultaneously tested using MODS and the BACTEC MGIT 960 mycobacterial detection system for the detection of M. tuberculosis and the identification of MDR-TB samples.
  
  
  RESULTS
  MODS detected 112 (97.4%) samples and BACTEC MGIT detected 115 (100%). Of the 115 isolates tested for susceptibility to INH, RMP and MDR-TB, complete agreement between MODS and MGIT results was found among respectively 92.9%, 95.5% and 97.3% of samples. The sensitivity, specificity, and positive and negative predictive values of MODS in the detection of MDR-TB were respectively 95.3%, 98.6%, 97.6% and 97.1%. MODS results were obtained in a median of 8 days (range 5-21).
  
  
  CONCLUSIONS
  MODS is an optimal alternative method for timely and affordable identification of MDR-TB in resource-limited settings.
authors.affiliation: Department of Microbiology and Immunology, Ain Sham University, Faculty of Medicine, Cairo, Egypt.
authors.forename: O
authors.initials: O
authors.lastname: Rasslan
authors.forename: S F
authors.initials: SF
authors.lastname: Hafez
authors.forename: M
authors.initials: M
authors.lastname: Hashem
authors.forename: O I
authors.initials: OI
authors.lastname: Ahmed
authors.forename: M A S
authors.initials: MA
authors.lastname: Faramawy
authors.forename: W S
authors.initials: WS
authors.lastname: Khater
authors.forename: D A
authors.initials: DA
authors.lastname: Saleh
authors.forename: M I
authors.initials: MI
authors.lastname: Mohamed
authors.forename: M A M
authors.initials: MA
authors.lastname: Khalifa
authors.forename: F A
authors.initials: FA
authors.lastname: Shoukry
authors.forename: E H
authors.initials: EH
authors.lastname: El-Moghazy
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology*; D004534:Egypt; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology*; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods*; D008853:Microscopy; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D011237:Predictive Value of Tests; D012293:Rifampin / Q000494:pharmacology*; D012680:Sensitivity and Specificity; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000188:drug therapy; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin