title: Performance of REBA MTB-XDR to detect extensively drug-resistant tuberculosis in an intermediate-burden country.
abstract: Extensively drug-resistant tuberculosis (XDR-TB) is a serious worldwide problem. The REBA MTB-XDR (REBA-XDR) was recently developed in Korea to detect resistance to ofloxacin, kanamycin, and streptomycin. The aim of this study is to evaluate the diagnostic accuracy of the REBA-XDR. We prospectively enrolled 104 patients with acid-fast bacilli smear-positive specimens between July 2010 and January 2013. Performance characteristics were compared between REBA-XDR and conventional drug-susceptibility testing. The sensitivity values of REBA-XDR for detecting resistance to ofloxacin, kanamycin, and streptomycin were 66.7%, 90.9%, and 60.0%, and the specificity values were 93.3%, 93.5%, and 85.4%, respectively. The positive predictive values were 62.5%, 62.5%, and 40.9%, and the negative predictive values were 94.3%, 98.9%, and 92.7%, respectively. Accuracy was 89.4%, 93.3%, and 81.7%, respectively. REBA-XDR seems to be a useful kit for "ruling in" XDR-TB in intermediate-burden countries, and especially useful for detecting kanamycin resistance.
authors: Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors: Young Seok
authors: YS
authors: Lee
authors: YD R&D Center, YD Diagnostics, South Korea.
authors: Mi Ran
authors: MR
authors: Kang
authors: Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea.
authors: Hoon
authors: H
authors: Jung
authors: Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea.
authors: Sang Bong
authors: SB
authors: Choi
authors: Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
authors: Kyung-Wook
authors: KW
authors: Jo
authors: Department of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea. Electronic address: shimts@amc.seoul.kr.
authors: Tae Sun
authors: TS
authors: Shim
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial; D054908:Extensively Drug-Resistant Tuberculosis / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D019450:Genes, MDR; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology; D007612:Kanamycin / Q000494:pharmacology; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics*; D015242:Ofloxacin / Q000494:pharmacology; D011237:Predictive Value of Tests; D056910:Republic of Korea; D012293:Rifampin / Q000494:pharmacology; D013183:Sputum / Q000382:microbiology; D013307:Streptomycin / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D007612:Kanamycin; D015242:Ofloxacin; D007538:Isoniazid; D012293:Rifampin; D013307:Streptomycin
keywords: Extensively drug-resistant tuberculosis; Kanamycin; Molecular probes; Nucleic acid hybridization; Ofloxacin