Performance of REBA MTB-XDR to detect extensively drug-resistant tuberculosis in an intermediate-burden country

Lee, Young Seok; Kang, Moon Gi; Jung, Hoon; Choi, Sang Bong; Jo, Kyung‐Wook; Shim, Tae Sun

doi:10.1016/j.jiac.2014.12.009

Cited by 8 publications

(1 citation statement)

References 37 publications

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“…Up to date, many researchers have reported DNA-based methods for TB detection and antibiotics selection, such as polymerase chain reaction (PCR) and real-time PCR (Bang et al, 2011;Cho et al, 2013;Lee et al, 2015). The DNAbased methods have produced quite comparable results with those from bacterial culture methods (Bang et al, 2011;Gous et al, 2015;Munkhdelger et al, 2013;Pai and Schito, 2015).…”

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confidence: 99%

Mycobacterium tuberculosisDNA Detection and Molecular Drug Susceptibility Test in AFB-stained Sputum Slides

Jung

Lee

Park

2016

BSL

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Tuberculosis (TB) remains an unsolved community health problem since identification of its causing microorganism called Mycobacterium tuberculosis (MTB) by Robert Koch in 1882. Annually, eight million TB cases are newly reported and 2~3 million patients die from TB. Pulmonary TB is highly infectious and untreated pulmonary TB patients are believed to infect >10 people in a year. The conventional methods for diagnosis of TB are chest X-ray and isolation of the causing microorganisms from patient specimens. Screening of TB is conducted with smeared sputum in slides, and TB is confirmed by identification of MTB in cultured specimens. One of the fatal pitfalls of screening detection for smeared sputum is that it is impossible to distinguish MTB and other acid-fast bacilli (AFB) because they are stained equally with Ziehl-Neelsen (ZN) stain. Culture of MTB is the most reliable method for diagnosis of TB but it takes 4~8 weeks. In this report, we suggest a fast and highly-reliable MTB detection method that distinguishes AFB in sputum samples. Purified DNA from the AFB stained slide samples offered by The Korean Institute of Tuberculosis were used to detect infected MTB in patients. PCR, real-time PCR and reverse blot hybridization assay (REBA) methods were applied to purified DNA. Conclusively, the real-time PCR method was confirmed to produce high sensitivity and we were able to further detect drug-resistant MTB with REBA. RESULTS AND DISCUSSIONTuberculosis (TB) remains an unsolved community health problem since identification of its causing microorganism called Mycobacterium tuberculosis (MTB) by Robert Koch in 1882. According to the World Health Organization (WHO) report there were eight million new TB cases and deaths of two to three million patients by TB in a year. Forty thousand new TB cases and three thousand deaths occur in the Republic of Korea every year (Dye et al., 1999;Lew et al., 1995). Microscopic detection method for smeared sputum is a conventional method that detects acid-fast bacilli (AFB) using Ziehl-Neelsen (ZN) staining. However, it has low sensitivity: at least 5,000~10,000 AFB are required per ml for detection and is impossible to distinguish MTB from Brief Communication *

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Mycobacterium tuberculosisDNA Detection and Molecular Drug Susceptibility Test in AFB-stained Sputum Slides

Jung

Lee

Park

2016

BSL

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Xpert MTB/XDR for detection of pulmonary tuberculosis and resistance to isoniazid, fluoroquinolones, ethionamide, and amikacin

Pillay

Steingart

Davies

et al. 2022

Cochrane Database of Systematic Reviews

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Background The World Health Organization (WHO) End TB Strategy stresses universal access to drug susceptibility testing (DST). DST determines whether Mycobacterium tuberculosis bacteria are susceptible or resistant to drugs. Xpert MTB/XDR is a rapid nucleic acid amplification test for detection of tuberculosis and drug resistance in one test suitable for use in peripheral and intermediate level laboratories. In specimens where tuberculosis is detected by Xpert MTB/XDR, Xpert MTB/XDR can also detect resistance to isoniazid, fluoroquinolones, ethionamide, and amikacin. Objectives To assess the diagnostic accuracy of Xpert MTB/XDR for pulmonary tuberculosis in people with presumptive pulmonary tuberculosis (having signs and symptoms suggestive of tuberculosis, including cough, fever, weight loss, night sweats). To assess the diagnostic accuracy of Xpert MTB/XDR for resistance to isoniazid, fluoroquinolones, ethionamide, and amikacin in people with tuberculosis detected by Xpert MTB/XDR, irrespective of rifampicin resistance (whether or not rifampicin resistance status was known) and with known rifampicin resistance. Search methods We searched multiple databases to 23 September 2021. We limited searches to 2015 onwards as Xpert MTB/XDR was launched in 2020. Selection criteria Diagnostic accuracy studies using sputum in adults with presumptive or confirmed pulmonary tuberculosis. Reference standards were culture (pulmonary tuberculosis detection); phenotypic DST (pDST), genotypic DST (gDST),composite (pDST and gDST) (drug resistance detection). Data collection and analysis Two review authors independently reviewed reports for eligibility and extracted data using a standardized form. For multicentre studies, we anticipated variability in the type and frequency of mutations associated with resistance to a given drug at the different centres and considered each centre as an independent study cohort for quality assessment and analysis. We assessed methodological quality with QUADAS‐2, judging risk of bias separately for each target condition and reference standard. For pulmonary tuberculosis detection, owing to heterogeneity in participant characteristics and observed specificity estimates, we reported a range of sensitivity and specificity estimates and did not perform a meta‐analysis. For drug resistance detection, we performed meta‐analyses by reference standard using bivariate random‐effects models. Using GRADE, we assessed certainty of evidence of Xpert MTB/XDR accuracy for detection of resistance to isoniazid and fluoroquinolones in people irrespective of rifampicin resistance and to ethionamide and amikacin in people with known rifampicin resistance, reflecting real‐world situations. We used pDST, except for ethionamide resistance where we considered gDST a better reference standard. Main results W...

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Advances in the Diagnosis of Mycobacterium tuberculosis Infection

Silva

Pina

Rêgo

et al. 2018

Advanced Techniques in Diagnostic Microbiology

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Performance of REBA MTB-XDR to detect extensively drug-resistant tuberculosis in an intermediate-burden country

Cited by 8 publications

References 37 publications

Mycobacterium tuberculosisDNA Detection and Molecular Drug Susceptibility Test in AFB-stained Sputum Slides

Mycobacterium tuberculosisDNA Detection and Molecular Drug Susceptibility Test in AFB-stained Sputum Slides

Xpert MTB/XDR for detection of pulmonary tuberculosis and resistance to isoniazid, fluoroquinolones, ethionamide, and amikacin

Advances in the Diagnosis of Mycobacterium tuberculosis Infection

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