Rapid Diagnosis of Tuberculosis and Multidrug Resistance by the Microscopic-Observation Drug-Susceptibility Assay

Shah, Neha; Moodley, Prashini; Babaria, Palav; Moodley, Salona; Ramtahal, Melissa; Richardson, Jessica; Heysell, Scott K; Li, Xuan; Moll, Anthony; Friedland, Gerald; Sturm, A. Willem; Gandhi, Neel R.

doi:10.1164/rccm.201009-1449oc

Cited by 45 publications

(38 citation statements)

References 26 publications

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“…All except one were performed in urban settings [40]. The patients included in the studies varied in race (Afro-American, Asiatic and Hispanic) and age; seven studies included adult patients (mean age 30-35 years) [30,32,[35][36][37][38]40] and two studies focused on children [36,39]. A variety of samples were cultured: sputum, induced sputum, string, gastric aspirates, nasopharyngeal aspirates, cerebrospinal fluid (CSF), pleural fluid and stool specimens.…”

Section: Resultsmentioning

confidence: 99%

“…MAKAMURE [37] HA [32] SOLOMON [41] VARGAS [ HA [36) HA [32] MAKAMURE [37] SHAH [40] SOLOMON [41] REDDY [30] MOORE [38] VARGAS [ MAKAMURE [37] SOLOMON [41] MOORE [38] REDDY [30] CAWS [35] HA [36] HA [32] MAKAMURE [37] SHAH [40] SOLOMON [41] REDDY [30] MOORE [38) VARGAS [ The greatest limitation of this study is the small number of studies included, as the number of studies evaluating MODS in PLWH is low. Moreover, many studies assessing the performance of MODS performed in settings with a high prevalence of HIV infection do not report separate data for PLWH and, in some of them, HIV testing was not systematically performed in TB patients [53][54][55].…”

Section: First Author [Ref]mentioning

confidence: 99%

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Microscopic observation drug susceptibility assay for the diagnosis of TB and MDR-TB in HIV-infected patients: a systematic review and meta-analysis

Wikman-Jorgensen

Llenas-García²,

Hobbins³

et al. 2014

Eur Respir J

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The objective of the present study was to assess the diagnostic accuracy of the microscopic observation drug susceptibility (MODS) assay for tuberculosis (TB) diagnosis in HIV-infected patients.MEDLINE, EMBASE, LILACS, the Cochrane Central Register of Controlled Trials, African Index Medicus, ResearchGate, SciELO, and the abstracts of the main conferences on infectious diseases and tropical medicine were searched, and other sources investigated. Only studies including HIV-infected patients evaluating MODS for the diagnosis of TB and using culture-based diagnostic tests as a gold standard were analysed. Summary sensitivity and specificity were calculated with a bivariate model. 3259 citations were found, 29 were selected for full-text review and 10 studies including 3075 samples were finally analysed. Overall diagnostic accuracy of MODS for the diagnosis of TB was a sensitivity of 88.3% (95% CI 86.18-90.2%) and specificity 98.2% (95% CI 97.75-98.55%). For multidrug-resistant (MDR)-TB, sensitivity was 89% (95% CI 66.07-97%) and specificity was 100% (95 CI 94.81-100%). For smear-negative pulmonary TB, a sensitivity of 88.2% (95% CI 86.1-89.9%) and specificity of 98.2% (95% CI 96.8-98.9%) were found. Costs varied between USD 0.72 and 7.31 per sample. Mean time to positivity was 8.24 days.MODS was found to have a good accuracy for the diagnosis of TB and MDR-TB in HIV-infected patients with low cost and fast results. @ERSpublications MODS is an accurate, cheap and fast, culture-based technique for diagnosis of TB and MDR-TB in HIV-infected patients

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Section: Resultsmentioning

confidence: 99%

Section: First Author [Ref]mentioning

confidence: 99%

Microscopic observation drug susceptibility assay for the diagnosis of TB and MDR-TB in HIV-infected patients: a systematic review and meta-analysis

Wikman-Jorgensen

Llenas-García²,

Hobbins³

et al. 2014

Eur Respir J

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“…The prolonged detection time (8)(9)(10)(11)(12) weeks) for Mycobacterium tuberculosis [MTB] growth, detection, identification and drug susceptibility testing [DST]) means, however, that patients may be treated inappropriately, leading to the spread of drug resistant strains in the community.…”

Section: Introductionmentioning

confidence: 99%

“…Each technique has advantages and limitations, particularly with regards to cost, infrastructural requirements and time to detection. Using GeneXpert-MTB/RIF, the median time from sample collection to detection of resistance to rifampicin is 2 days, compared with 7 days using MODS, 24 days using MGIT-DST and many weeks using LJ-DST [9,10]. GeneXpert-MTB/RIF however detects resistance only to RIF and so is only a surrogate marker for MDR-TB [11] and for confirmation, other tests such as culture are required.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, recent evidence suggests that its value is not the same in all settings [12]. MODS can be used to determine susceptibility to both RIF and INH, enabling confirmation of an isolate as MDR-TB, but resistance to other antibiotics included in standard first line treatment is not reliable [9,10]. The MGIT-DST system, shows high correlation with conventional solid culture DST for detection of resistance to both first and secondline anti-TB drugs, but it is more expensive, limiting its availability in developing countries [13,14].…”

Section: Introductionmentioning

confidence: 99%

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A suggested algorithm for detection of multi drug-resistant tuberculosis in Zimbabwe

Makamure

Makumbirofa

Bandason

et al. 2017

J Infect Dev Ctries

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Introduction: Rapid genotypic and phenotypic methods for multi-drug-resistant-tuberculosis (MDR-TB) detection are now widely available. Zimbabwe adopted the use of GeneXpert-MTB/RIF, microscopic-observation-drug-susceptibility-assay (MODS) and Mycobacteria-GrowthIndicator-Tube (MGIT) drug-susceptibility-testing (DST). Data is limited on the ideal combination of use of these methods in resource limited settings. Methodology: Between August 2014 to July 2015, 211 sputa from MDR-TB suspects were tested with GeneXpert-MTB/RIF, MODS, manual-MGIT and Lowenstein-Jensen (LJ)-DST to determine diagnostic accuracy and turnaround-time (TAT), with LJ-DST as the gold standard. A performance score ranking table for diagnostic accuracy, TAT, costs, facilities and expertise requirements, was used to determine the most favourable tool. Results: GeneXpert-MTB/RIF sensitivity was 96% (95%CI:80-100) and specificity was 95% (95%CI:90-97). MODS sensitivity was 88% (95%CI:68-97) and specificity was 97% (95%CI:87-100). Manual MGIT-DST had slightly lower sensitivity of 80% (95%CI:59-93). Median time to detection of MDR-TB was <1 day (IQR:0-0) for Xpert, 14 days (IQR:11-31) for MODS, 21 days (IQR:7-22) for MGIT-DST and 28 days (IQR:25-28) for LJ-DST. Operational costs for MODS, MGIT-DST, and GeneXpert-MTB/RIF were $21.20, $27.52 and $39.76 respectively. From a summation of scores including facility and expertise requirements per diagnostic technique, GeneXpert-MTB/RIF was the most favourable tool, followed by MODS and MGIT-DST. Conclusions: For best scale-up of MDR-TB diagnosis in Zimbabwe, GeneXpert-MTB/RIF can be used for rapid detection of TB in smear negative cases, RIF-susceptibility for early treatment initiation and probable MDR-TB. MODS can rapidly confirm probable MDR-TB detected by GeneXpert-MTB/RIF, manual-MGIT can provide early results for susceptibility to other antibiotics, with affordable costs, with LJ-DST confirming discordant DSTs.

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Drug-Resistant Tuberculosis and HIV

Auld

Gandhi

Brust

2019

HIV and Tuberculosis

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Rapid Diagnosis of Tuberculosis and Multidrug Resistance by the Microscopic-Observation Drug-Susceptibility Assay

Cited by 45 publications

References 26 publications

Microscopic observation drug susceptibility assay for the diagnosis of TB and MDR-TB in HIV-infected patients: a systematic review and meta-analysis

Microscopic observation drug susceptibility assay for the diagnosis of TB and MDR-TB in HIV-infected patients: a systematic review and meta-analysis

A suggested algorithm for detection of multi drug-resistant tuberculosis in Zimbabwe

Drug-Resistant Tuberculosis and HIV

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