Drug-Resistant Tubercular Uveitis

Sharma, Kusum; Sharma, Aman; Bansal, Reema; Fiorella, Paul D.; Ak, Gupta

doi:10.1128/jcm.01918-14

Cited by 18 publications

(3 citation statements)

References 6 publications

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“…The mutations were detected at codon 531 (n = 4), 526 (n = 1), and 516 (n = 1) in the rpoB gene; and codon 315 (n = 2) of the katG gene. The findings are similar to results obtained in previous studies 16,20,21,25 as these are the most commonly encountered mutations contributing to drug resistance for rifampicin and isoniazid, respectively.…”

Section: Discussionsupporting

confidence: 91%

“…MTBDRplus line probe assay is a commercially available diagnostic technique that is currently recommended for smear positive pulmonary specimen and from culture. 14 To the best of our knowledge, there are only two studies 15,16 addressing the role of MTBDRplus assay, on 11 and five cases, respectively, for the diagnosis of IOTB and detection of resistance simultaneously. We, therefore, evaluated the diagnostic potential of MTBDRplus assay on substantial number of vitreous fluid samples to add to the existing literature in this field.…”

Section: Introductionmentioning

confidence: 99%

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MTBDRplus for the rapid diagnosis of ocular tuberculosis and screening of drug resistance

Sharma

Gupta

Sharma

et al. 2017

Eye

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PurposeTimely diagnosis of intraocular tuberculosis (IOTB) along with detection of drug resistance can save many eyes from visual impairment. With the growing incidence of IOTB and rising drug resistance, a reliable diagnostic platform for simultaneous detection of the agent and mutated gene is urgently needed. The MTBDRplus assay was evaluated directly on vitreous fluid samples for the same.Patients and methodsIn a prospective study, The MTBDRplus assay was performed on 127 vitreous fluid samples (77 'study group' comprising cases of presumed ocular tuberculosis and 50 'control group' cases of disease controls (n=25) and non-uveitic controls (n=25)). All samples positive by MTBDRplus assay were subjected to gene sequencing to confirm the mutations for rifampicin and isoniazid resistance.ResultsThe MTBDRplus assay produced a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 36.36%, 100%, 100%, and 50.50%, respectively, for the detection of IOTB. Among the 28 cases from study group that were positive by MTBDRplus assay, rifampicin resistance was reported in six and isoniazid resistance in two cases. On sequencing of rpoB and katG gene, one case of false rifampicin-resistant by MTBDRplus was found. The other resistant isolates showed concordant mutations between MTBDRplus assay and sequencing.ConclusionThe MTBDRplus assay is an effective tool for the rapid diagnosis of IOTB along with detection of drug resistance, thereby improving the outcome in IOTB.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

MTBDRplus for the rapid diagnosis of ocular tuberculosis and screening of drug resistance

Sharma

Gupta

Sharma

et al. 2017

Eye

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show abstract

“…[ 22 ] I also described ocular signs predictive of tubercular uveitis (Scopus citations, 158). [ 23 ] In 2014, we reported multidrug resistant tubercular uveitis for the first time globally,[ 24 ] and in 2015, its successful treatment. [ 25 ] We were among the first in the world to successfully treat TB choroidal granuloma with anti-vascular endothelial growth factor (anti-VEGF), exploiting the vascularization of hypoxic TB granulomas.…”

Section: Beginning Of a Cascade In Ocular Tb Researchmentioning

confidence: 99%