title: Detection of multidrug-resistant tuberculosis using MGIT™(TM) and MAS-PCR in Tripura, India.
abstract: BACKGROUND
  Multidrug-resistant tuberculosis (MDR-TB) poses a global threat that is further compounded by the human immunodeficiency virus (HIV) epidemic.
  
  
  OBJECTIVE
  To detect MDR-TB among pulmonary TB (PTB) patients with or without HIV coinfection by isolating and identifying Mycobacterium tuberculosis from clinical samples and performing drug susceptibility testing (DST).
  
  
  METHODS
  Sputum was collected from presumed PTB cases. Microscopic examination was performed following Ziehl-Neelsen (ZN) staining and cultured in Löwenstein-Jensen (LJ) medium. First-line anti-tuberculosis DST of the isolates was performed using MGIT™ (Mycobacterial Growth Indicator Tube) and multiplex allele-specific polymerase chain reaction (MAS-PCR).
  
  
  RESULTS
  Of 172 study subjects, 59.3% (102/172) were smear-positive and 40.7% (70/172) were smear-negative. In the smear-positive and -negative groups, respectively 62.7% (64/102) and 8.6% (6/70) were culture-positive. DST on MGIT showed a cumulative resistance of 7.1% (5/70) to isoniazid (INH) and rifampicin. More ethambutol (EMB) and combined INH+EMB resistance was detected using MAS-PCR.
  
  
  CONCLUSIONS
  MDR-TB is a problem in Tripura, and culture and phenotypic DST are required for diagnosis. MAS-PCR may provide an alternative rapid screening tool.
authors.affiliation: Department of Microbiology, Agartala Government Medical College, Agartala, India.
authors.forename: T
authors.initials: T
authors.lastname: Majumdar
authors.affiliation: Department of Microbiology, Agartala Government Medical College, Agartala, India.
authors.forename: S
authors.initials: S
authors.lastname: Bhattacharya
authors.affiliation: Department of Microbiology, Agartala Government Medical College, Agartala, India.
authors.forename: D
authors.initials: D
authors.lastname: Barman
authors.affiliation: Department of Medicine, Agartala Government Medical College, Agartala, India.
authors.forename: P
authors.initials: P
authors.lastname: Bhoumik
authors.affiliation: Department of Microbiology, Agartala Government Medical College, Agartala, India.
authors.forename: R
authors.initials: R
authors.lastname: Bir
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D060085:Coinfection; D004269:DNA, Bacterial / Q000235:genetics*; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000175:diagnosis / Q000821:virology; D006801:Humans; D007194:India; D008297:Male; D008826:Microbial Sensitivity Tests; D008853:Microscopy; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D060885:Multiplex Polymerase Chain Reaction; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D010641:Phenotype; D011237:Predictive Value of Tests; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D004269:DNA, Bacterial