Line probe assay for detection of Mycobacterium tuberculosis complex: An experience from Central India

Desikan, Prabha; Panwalkar, Nikita; Mirza, Shaina Beg; Chaturvedi, Aparna; Ansari, Kudsia; Varathe, Reeta; Chourey, Manju; Kumar, Pradeep; Pandey, Manoj

doi:10.4103/ijmr.ijmr_831_14

Cited by 22 publications

(12 citation statements)

References 6 publications

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“…(6/95) and INH 2.1% (2/95) mono-resistance, the current prevalence in line with a number of studies [18,29,30] that rifampicin mono-resistant is greater than isoniazid mono-resistant with varying degrees of proportion. Such RIF resistance is an important implication for higher risk of multi-drug resistance as it is a surrogate marker of MDR [28].…”

Section: Socio-demographic Characteristics Genotypic and Phenotypic supporting

confidence: 79%

Phenotypic and genotypic drug sensitivity profiles of Mycobacterium tuberculosis infection and associated factors in northeastern Ethiopia

Gashaw

Erko

Mekonnen

et al. 2020

Preprint

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Background Tuberculosis is a devastating and a deadly disease despite the novel advances in its diagnostic tools and drug therapy. Drug resistant Mycobacterium contributes a great share to tuberculosis mortality. Status of drug resistance and patients’ awareness toward the disease is unknown in northeastern Ethiopia. Thus, the aim of this study was to determine the phenotypic and genotypic drug sensitivity patterns and associated factors in Oromia Special Zone and Dessie Town, northeastern Ethiopia. Methods In a cross-sectional study, 384 smear positive tuberculosis cases were recruited and Löwenstein-Jensen culture was done. The performance of GenoTypic MTBDRplus assay using the conventional BACTEC MGIT 960 as a "gold standard" was determined. Drug resistant strains were identified using spoligotyping. Pearson Chi-square test was used to determine the association of drug sensitivity test and tuberculosis type, lineages, dominant strains and clustering of the isolates. For the assessment of patients’ awareness towards the disease questionnaires were used. Results A fair agreement was found between MTBDRplus assay and the conventional MGIT test in detecting the Mycobacterium tuberculosis with sensitivity, specificity, positive and negative predictive value of 94.2%, 30.2%, 68.4% and 76.5%, respectively. The MTBDRplus assay detected 16.8% (16/95) of the isolates as drug resistant and MGIT detected a comparable number 15.9% (11/69) as resistant. Cohen's kappa value showed almost a perfect agreement between the two testing methods in detecting rifampicin (sensitivity 100% and specificity 98.3%) and multi-drug resistance (sensitivity 83.3% and specificity 100%). Spoligotyping identified 76.5% (13/17) of the drug resistant isolates as Euro-American and family 33 as the predominant family. Significant association was observed between drug resistant isolates and the dominant strains (χ2: 34.861; p = 0.040). Majority of the patients heard about tuberculosis as compared to drug resistant Mycobacterium. Conclusion Higher magnitude of drug resistance was found in the study area. The GenoTypic MDRTBplus assay had an acceptable drug sensitivity testing performance. Patients’ awareness towards the disease specifically to the resistant Mycobacterium was low.

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Section: Socio-demographic Characteristics Genotypic and Phenotypic supporting

confidence: 79%

Phenotypic and genotypic drug sensitivity profiles of Mycobacterium tuberculosis infection and associated factors in northeastern Ethiopia

Gashaw

Erko

Mekonnen

et al. 2020

Preprint

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“…Genotype Mycobacterium tuberculosis drug resistance (MTBDR) plus test is a WHO‐endorsed line‐probe assay for the rapid detection of Mycobacterium tuberculosis complex (MTB) and mutations conferring resistance to Rifampicin (RIF) and Isoniazid (INH) in AFB smear‐positive sputum specimens. In the above‐discussed case, the acid‐fast bacilli were negative for MPT 64 which is a Mycobacterium tuberculosis ‐specific antigen but the isolate when subjected to Genotype MTBDR plus test confirmed to be a member of Mycobacterium tuberculosis complex …”

Section: Discussionmentioning

confidence: 93%

“…to be a member of Mycobacterium tuberculosis complex. 8,9 No clear guidelines are defined for treatment of BCGosis, however, most suitable treatment given involves administration of four drugs (Isoniazid, Rifampicin, Ethambutol, and Pyrazinamide) to reduce the BCG load. Disseminated BCGosis is associated with very high mortality; however, survival has been documented in timely identification of these cases with appropriate management.…”

mentioning

confidence: 99%

Cytological diagnosis in a clinically unsuspected case of disseminated BCGosis: A case report

Mittal

Mahajan

Khatri

et al. 2019

Diagnostic Cytopathology

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Bacille Calmette‐Guerin (BCG) vaccine is administered worldwide to neonates and considered safe. Serious complications like disseminated BCGosis are extremely rare occurrences (<1 per million vaccinations). A 6 months male was brought to paediatric outpatient department with fever and swelling over the dorsum of the left hand for 5 days. On examination, he was febrile and had hepatosplenomegaly. X‐ray of the hand showed lytic lesions in the first and second metacarpals. Provisional clinical diagnosis included Langerhans cell histiocytosis, congenital syphilis, and haematological malignancy. Fine Needle Aspiration Cytology (FNAC) was done from the swelling and showed diffuse sheets of histiocytes with both intracellular and extracellular rod‐shaped unstained structures along with inflammatory cells. These ghost images stained positive with ZN stain. A cytological diagnosis of atypical mycobacteria vs leprosy was made. Child was revisited and found to have an active BCG scar. Further investigations showed low serum IgM and positive AFB culture. These bacilli were confirmed by GenoType MTBDR plus test as Mycobacterium bovis. Despite Antitubercular therapy, the patient succumbed to death. This case highlights the variable clinical presentation of BCGosis. Its occurrence may unmask any underlying immunodeficiency. If unfamiliar with the above cytological features and in absence of routinely performed special stains, the cytopathologist may miss these notorious organisms and treat such cases like suppurative lesions. To conclude, an early and definitive diagnosis of BCGosis can be established on FNAC which would ensure timely management and better outcome in this highly lethal entity.

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“…Authors used line probe assay to do this study as it has been shown to have be a robust technique for diagnosis of drug-resistant TB and it has also provided the basis for rapid and effective control of drug-resistant TB in India. 9 This test has also proved highly accurate in the rapid detection of R resistance in a multi-site validation in India though in a study from Punjab 2.7% of the specimens were found to be invalid. 10,11 LPA was also associated with a major reduction in the delay between identification of patients suspected for MDR-TB and initiation of treatment, attributed mainly to a reduction in diagnostic time.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of primary drug resistance to rifampicin and isoniazid in newly diagnosed sputum smear positive pulmonary Tuberculosis

et al. 2019

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Background: To determine the prevalence of primary drug resistance to either rifampicin or isoniazid alone or both in newly diagnosed sputum smear positive pulmonary tuberculosis patients.Method: A prospective study 100 newly diagnosed sputum smear positive pulmonary TB patients was conducted. The patients with an age of ≥15 years and who had either not taken anti TB treatment or who had taken ATT for less than 1 month were enrolled in this study. Two sputum samples (5ml each), including one early morning sample as per the RNTCP guidelines were collected and subjected to line probe assay (LPA).Results: Out of 100 cases 6 were having resistance to both rifampicin and isoniazid, 9 has resistance to INH alone and 1 had resistance to rifampicin alone.Conclusion: The prevalence of primary drug resistance is high. For early and rapid detection of DR-TB newer modality should be used for the detection of primary drug resistance in sputum smear positive TB patients.

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Line probe assay for detection of Mycobacterium tuberculosis complex: An experience from Central India

Cited by 22 publications

References 6 publications

Phenotypic and genotypic drug sensitivity profiles of Mycobacterium tuberculosis infection and associated factors in northeastern Ethiopia

Phenotypic and genotypic drug sensitivity profiles of Mycobacterium tuberculosis infection and associated factors in northeastern Ethiopia

Cytological diagnosis in a clinically unsuspected case of disseminated BCGosis: A case report

Prevalence of primary drug resistance to rifampicin and isoniazid in newly diagnosed sputum smear positive pulmonary Tuberculosis

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