Comparative Performance of Line Probe Assay and GeneXpert in the Detection of Rifampicin Monoresistance in a TB-Endemic African Country

Mchaki, Betty R.; Mgaya, Fauster X.; Kunambi, Peter P.; Hang’ombe, Bernard M.; Matee, Mecky; Munyeme, Musso

doi:10.3390/antibiotics11111489

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…The LiPA further complements the Xpert MTB/RIF screening assay by validating rifampicin susceptibility and providing information on isoniazid susceptibility [21]. Reports further suggest that LiPA has a better diagnostic performance characteristic compared to GeneXpert when using smear microscopy as the gold standard [22][23][24], or the phenotypic proportion method on Lowenstein-Jensen media as the gold standard [25]. We applied the LiPA to analyse clinical specimens obtained from suspected EPTB patients reporting to the TTH to determine the prevalence of MTBC strains and their resistance to isoniazid and rifampicin.…”

Section: Discussionmentioning

confidence: 99%

Extrapulmonary tuberculosis in Africa: Molecular analysis of clinical specimens of suspected cases in Northern Ghana

Addai,

Acquah,

Ganu

et al. 2024

Public Health Challenges

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BackgroundExtrapulmonary tuberculosis (EPTB) is a major component of the total tuberculosis cases reported by the World Health Organization. This is a study conducted to compare microscopy and molecular techniques to determine the prevalence of Mycobacterium tuberculosis complex (MTBC) in EPTB patients.MethodsSmear microscopy and genotype MTBDRplus line probe assay (LiPA) were applied to concentrated extrapulmonary clinical specimens from different anatomic sites to determine the presence of M. tuberculosis and their susceptibility to isoniazid (INH) and/or rifampin (RIF).ResultsA total of 251 specimens comprising 108 (43%) ascitic fluid, 54 (21.5%) pleural aspirate, 24 (9.6%) gastric lavage, 15 (6.0%) pus, 9 (3.6%) synovial fluid, 5 (2%) cerebrospinal fluid, 2 (0.8%) breast aspirate and 34 (13.5%) aspirates from unindicated sites obtained from patients with suspected EPTB attending the Tamale Teaching Hospital were analysed. Microscopically, acid fast bacilli (AFB) were detected in one ascitic fluid and a pus specimen. Using the LiPA, MTBC was observed in four (2.6%) samples; three (3) ascitic fluid and one aspirate.ConclusionM. tuberculosis complex was confirmed in four (2.6%) patients. The most common specimens suspected of EPTB were ascitic fluid, pleural aspirate and gastric lavage. However, MTBC was predominantly detected in ascitic fluid. This result indicates that the LiPA can improve the detection of EPTB in the region and similar settings globally.

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Section: Discussionmentioning

confidence: 99%

Extrapulmonary tuberculosis in Africa: Molecular analysis of clinical specimens of suspected cases in Northern Ghana

Addai,

Acquah,

Ganu

et al. 2024

Public Health Challenges

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A systematic review on cost-effectiveness of diagnostic methods and treatments for tuberculosis in India

Balakrishnan,

Varadharajan,

Gajendran

2024

Indian Journal of Tuberculosis

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Can resistance to either isoniazid or rifampicin predict multidrug resistance tuberculosis (MDR-TB)

et al. 2023

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Background Previous studies have shown significant differences and lack clarity on whether resistance to either isoniazid or rifampicin can predict multidrug resistance tuberculosis (MDR-TB). Some consider rifampicin resistance to be a surrogate for MDR-TB. We, therefore, conducted this study to determine resistance to either isoniazid or rifampicin can predict MDR-TB. Results A total of 315 Mycobacteria tuberculosis isolates were tested for resistance against isoniazid, rifampicin, ethambutol and streptomycin using the phenotypic proportion method on Lowenstein–Jensen media. Results showed most isolates (88.9%, 280/315) were not resistant to any anti-TB tested, 5.7% (18/315) were resistant to both isoniazid and rifampicin, 2.5% (8/315) were resistant to rifampicin only and 1.3% (4/315) were resistant to all four first-line anti-tuberculosis. Prediction of MDR TB basing on rifampicin results showed sensitivity of 100.0%, specificity of 96.3%, diagnostic accuracy of 96.5%, and positive and negative predictive values of 62.1% and 100.0%, respectively. Isoniazid had sensitivity of 100.0%, specificity of 98.3%, diagnostic accuracy of 98.4%, and positive and negative predictive values of 78.3% and 100.0%, respectively. Prediction of rifampicin resistance based on isoniazid results had sensitivity of 62.1%, specificity of 98.3%, diagnostic accuracy of 94.9%, a positive predictive value of 78.3% and a negative predictive value of 96.2%. Conclusions Resistance to either rifampicin or isoniazid sub-optimally predicts MDR-TB. Despite having high sensitivity and specificity, the positive predictive value of rifampicin was only 62.1% and for isoniazid was 78.3%, suggesting that if either is tested in isolation both could result in false positives MDR-TB cases, resulting into patients being unnecessarily subjected to the more toxic and expensive second-line anti-TB drugs, which are less effective compared to first-line anti-TB drugs.

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Comparative Performance of Line Probe Assay and GeneXpert in the Detection of Rifampicin Monoresistance in a TB-Endemic African Country

Cited by 3 publications

References 27 publications

Extrapulmonary tuberculosis in Africa: Molecular analysis of clinical specimens of suspected cases in Northern Ghana

Extrapulmonary tuberculosis in Africa: Molecular analysis of clinical specimens of suspected cases in Northern Ghana

A systematic review on cost-effectiveness of diagnostic methods and treatments for tuberculosis in India

Can resistance to either isoniazid or rifampicin predict multidrug resistance tuberculosis (MDR-TB)

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