title: Concurrent evaluation of microscopic observation of drug susceptibility assay for pulmonary and extrapulmonary tuberculosis.
abstract: BACKGROUND
  Methods for detection and drug susceptibility of tuberculosis (TB) with solid media are inexpensive but slow and laborious. Rapid methods to diagnose TB and multidrug-resistant TB (MDR-TB) are a global priority for TB control.
  
  
  OBJECTIVE
  A study was performed to compare the sensitivity of detection of mycobacterial growth and time of culture positivity by microscopic observation of drug susceptibility (MODS) assay with that of Lowenstein-Jensen (LJ) culture in pulmonary and extrapulmonary TB and to evaluate the concordance of the susceptibilities to isoniazid (INH) and rifampicin (RIF) by MODS and proportion method on LJ.
  
  
  METHODS
  A prospective, laboratory-based study was conducted on a total of 300 samples from suspected cases of pulmonary and extrapulmonary TB. Samples were inoculated on LJ medium as per the standard guidelines and MODS assay was performed.
  
  
  RESULTS
  Sensitivity of MODS assay was 80% and 83.3% and specificity was 92.9% and 83.3% for pulmonary and extrapulmonary samples, respectively. Difference between mean time to detection ofMycobacteriumTB (MTB) by LJ medium and MODS was statistically significant, with MODS being faster. drug susceptibility testing (DST) by MODS when compared to economic variant of proportion method was 87.87% for RIF, 90.9% for INH, and 96.96% for MDR-TB detection.
  
  
  CONCLUSIONS
  MODS assay provides rapid, safe, and sensitive detection of TB faster than the existing gold standard. It is extremely promising in effectively diagnosing MDR-TB.
authors.affiliation: Department of Microbiology, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India.
authors.forename: Sonali Sudhir
authors.initials: SS
authors.lastname: Zadbuke
authors.affiliation: Department of Microbiology, T. N. M. C. and B. Y. L. Nair Ch. Hospital, Mumbai, Maharashtra, India.
authors.forename: Reena
authors.initials: R
authors.lastname: Set
authors.affiliation: Department of Microbiology, T. N. M. C. and B. Y. L. Nair Ch. Hospital, Mumbai, Maharashtra, India.
authors.forename: Nishat
authors.initials: N
authors.lastname: Khan
authors.affiliation: Department of Microbiology, T. N. M. C. and B. Y. L. Nair Ch. Hospital, Mumbai, Maharashtra, India.
authors.forename: Jayanthi
authors.initials: J
authors.lastname: Shastri
keywords: Extrapulmonary tuberculosis; microscopic observation of drug susceptibility assay; pulmonary tuberculosis