Susceptibility Testing with the Manual Mycobacteria Growth Indicator Tube (MGIT) and the MGIT 960 System Provides Rapid and Reliable Verification of Multidrug-Resistant Tuberculosis

Ådjers-Koskela, Kati; Katila, Marja–Leena

doi:10.1128/jcm.41.3.1235-1239.2003

Cited by 63 publications

(46 citation statements)

References 18 publications

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“…Concordance values were 96.3% for isoniazid, 98.8% for rifampin and ethambutol, and 97.5% for streptomycin. Previous studies that compared the automated BACTEC MGIT 960 and BACTEC 460TB methods obtained highly similar results (1,3,5,19,22).…”

Section: Discussionsupporting

confidence: 55%

Multicenter Laboratory Evaluation of the MB/BacT Mycobacterium Detection System and the BACTEC MGIT 960 System in Comparison with the BACTEC 460TB System for Susceptibility Testing of Mycobacterium tuberculosis

et al. 2007

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In this multicenter study, the reliability of two nonradiometric, fully automated systems, the MB/BacT and BACTEC MGIT 960 systems, for testing the susceptibilities of 82 Mycobacterium tuberculosis strains to isoniazid, rifampin, ethambutol, and streptomycin was evaluated in comparison with the radiometric BACTEC 460TB system. The arbitration of discrepant results was done by the reanalysis of the strain, the determination of the MIC, and the molecular characterization of some resistance determinants. The overall level of agreement with BACTEC 460TB results was 96% with the MB/BacT test and 97.2% with the BACTEC MGIT 960 system. With both methods, the level of agreement with BACTEC 460TB results was 96.3% for isoniazid, 98.8% for rifampin, and 98.8% for ethambutol. The level of agreement for streptomycin was 90.2% with MB/BacT and 97.5% with BACTEC MGIT 960. Overall, there were 11 very major errors and 2 major errors with the MB/BacT method and 5 very major errors and 2 major errors with the BACTEC MGIT 960 system. In general, the MB/BacT and BACTEC MGIT 960 systems showed good performance for susceptibility testing with first-line antituberculosis drugs.Tuberculosis (TB) is one of the most prevalent infectious diseases in the world. According to a recent report of the World Health Organization, in 2003 there were 8.8 million new TB cases and around 1.7 million deaths attributable to the disease (25). In addition, multidrug-resistant TB is becoming increasingly common and is a major health concern in many regions of the world, particularly in developing nations (24). Rapid, accurate diagnosis and the determination of drug susceptibility are crucial to optimize treatment and prevent transmission. The most widely used method for Mycobacterium tuberculosis drug susceptibility testing is the proportion method, either on solid medium or on liquid broth. The BACTEC 460TB system (Becton Dickinson Biosciences, Sparks, MD) has been widely validated for approximately 20 years for the reliable and rapid testing of the susceptibilities of M. tuberculosis isolates (9, 16, 21). The radiometric BACTEC 460TB test requires fewer than 14 days of incubation before results are available, but it is semiautomated and entails the disposal of a radioactive substance (16).New liquid medium-based systems have recently been introduced for the nonradiometric susceptibility testing of M. tuberculosis (4, 10, 17-19). These include the ESP Culture System II (AccuMed International, Westlake, OH), the MB Redox system (Biotest, Dreieich, Germany), the BACTEC MGIT 960 mycobacterial growth indicator tube system (Becton Dickinson Microbiology Systems, Sparks, MD), and the MB/BacT system (bioMérieux, Marcy l'Etoile, France).In the present multicenter study, we evaluated the reliability of the MB/BacT and BACTEC MGIT 960 systems for testing M. tuberculosis susceptibility to streptomycin, isoniazid, rifampin, and ethambutol (a combination known as SIRE) and compared the results obtained with these methods to those obtained with the radiometric BACTEC ...

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Section: Discussionsupporting

confidence: 55%

Multicenter Laboratory Evaluation of the MB/BacT Mycobacterium Detection System and the BACTEC MGIT 960 System in Comparison with the BACTEC 460TB System for Susceptibility Testing of Mycobacterium tuberculosis

et al. 2007

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“…Because of these shortcomings in the putative reference standards for determining second-line M. tuberculosis resistance status and the high degree of variability often seen between drug susceptibility methods [24,[30][31][32][33][34], we used a modified survival analysis to examine the response of the strains within samples to increasing concentrations of drugs in the MODS assay. This allowed us to differentiate visually between populations of bacteria, based on their response to drug concentrations, giving context to the critical concentrations beyond a potentially flawed comparison to other imperfect drug susceptibility tests.…”

Section: Kaplan-meier Survival Curvesmentioning

confidence: 99%

Second-line anti-tuberculosis drug concentrations for susceptibility testing in the MODS assay

Fitzwater

Sechler

Jave³

et al. 2012

Eur Respir J

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Multidrug-resistant tuberculosis (TB) threatens TB control worldwide. The microscopic observation drug susceptibility (MODS) assay is a low-cost, high-performance TB diagnostic tool for rapid liquid culture and direct isoniazid and rifampicin drug susceptibility testing (DST). The objective of this study was to explore the potential for extending the MODS assay to rapid second-line DST and to identify critical concentrations of candidate drugs for prospective testing.Sputum samples from 94 TB culture-positive patients receiving second-line TB agents were cultured following standardised MODS protocols, with a range of titrations of antimicrobial drugs added. Critical concentrations were determined using a modified Kaplan-Meier survival curve analysis.Candidate critical concentrations were determined for capreomycin (10 mg?mL -1 ), ciprofloxacin (1.25 mg?mL ) and streptomycin (10 mg?mL -1 ). No cut-off point was identified for the other second-line drugs or for pyrazinamide. At particular concentrations of some second-line TB drugs this novel Kaplan-Meier analysis clearly differentiated populations that were susceptible or resistant. These candidate critical concentrations should now be tested in a range of epidemiological settings to define the performance of direct, second-line TB DST with MODS, offering potential low-cost second-line TB DST capacity.

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“…The MGIT 960 system is FDA-approved for susceptibility testing of Mtb complex against the first-line drugs including RIF (2 µg/ml), INH (0.4 µg/ml and 0.1 µg/ml), and EMB (7.5 µg/ml and 2.5 µg/ml), PYZ (100 µg/ml) and streptomycin (STR, 6.0 µg/ml and 2.0 µg/ml) (CLSI, 2008). Evaluation of the MGIT performance for the primary tuberculosis drugs showed results that were comparable to the BACTEC 460 radiometric methods as well as the agar proportion methods (>90% agreement) (Ardito et al, 2001;Adjers-Koskela & Katila, 2003;Scarparo et al, 2004), except for EMB and STR which had agreement varying from less than 80% to 98% (Adjers-Koskela & Katila, 2003;Scarparo et al, 2004;Hall et al, 2006;Garrigo et al, 2007). More recently, the MGIT 960 was evaluated for susceptibility testing of second-line drugs including levofloxacin, amikacin, capreomycin and ethionamide with overall agreement of 96% at critical concentrations when compared to the agar proportion method (Lin et al, 2009).…”

Section: Rapid Broth Methodsmentioning

confidence: 96%

Clinical Laboratory Diagnostics for Mycobacterium tuberculosis

Babady¹,

Wengenack²

2012

Understanding Tuberculosis - Global Experiences and Innovative Approaches to the Diagnosis

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Susceptibility Testing with the Manual Mycobacteria Growth Indicator Tube (MGIT) and the MGIT 960 System Provides Rapid and Reliable Verification of Multidrug-Resistant Tuberculosis

Cited by 63 publications

References 18 publications

Multicenter Laboratory Evaluation of the MB/BacT Mycobacterium Detection System and the BACTEC MGIT 960 System in Comparison with the BACTEC 460TB System for Susceptibility Testing of Mycobacterium tuberculosis

Multicenter Laboratory Evaluation of the MB/BacT Mycobacterium Detection System and the BACTEC MGIT 960 System in Comparison with the BACTEC 460TB System for Susceptibility Testing of Mycobacterium tuberculosis

Second-line anti-tuberculosis drug concentrations for susceptibility testing in the MODS assay

Clinical Laboratory Diagnostics for Mycobacterium tuberculosis

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