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1.
Ahmet Yilmaz Coban 《Memórias do Instituto Oswaldo Cruz》2014,109(2):246-249
The aim of this study was to investigate the performance of a new and accurate method
for the detection of isoniazid (INH) and rifampicin (RIF) resistance among
Mycobacterium tuberculosis isolates using a crystal violet
decolourisation assay (CVDA). Fifty-five M. tuberculosis isolates
obtained from culture stocks stored at -80ºC were tested. After bacterial
inoculation, the samples were incubated at 37ºC for seven days and 100 µL of CV (25
mg/L stock solution) was then added to the control and sample tubes. The tubes were
incubated for an additional 24-48 h. CV (blue/purple) was decolourised in the
presence of bacterial growth; thus, if CV lost its colour in a sample containing a
drug, the tested isolate was reported as resistant. The sensitivity, specificity,
positive predictive value, negative predictive value and agreement for INH were
92.5%, 96.4%, 96.1%, 93.1% and 94.5%, respectively, and 88.8%, 100%, 100%, 94.8% and
96.3%, respectively, for RIF. The results were obtained within eight-nine days. This
study shows that CVDA is an effective method to detect M.
tuberculosis resistance to INH and RIF in developing countries. This
method is rapid, simple and inexpensive. Nonetheless, further studies are necessary
before routine laboratory implementation. 相似文献
2.
Ahmet Yilmaz Coban Ahmet Ugur Akbal Meltem Uzun Belma Durupinar 《Memórias do Instituto Oswaldo Cruz》2015,110(5):649-654
The purpose of this study is to evaluate four rapid colourimetric methods, including
the resazurin microtitre assay (REMA), malachite green decolourisation assay (MGDA),
microplate nitrate reductase assay (MNRA) and crystal violet decolourisation assay
(CVDA), for the rapid detection of multidrug-resistant (MDR) tuberculosis.
Fifty Mycobacterium tuberculosis isolates were used in this
study. Eighteen isolates were MDR, two isolates were only resistant to isoniazid
(INH) and the remaining isolates were susceptible to both INH and rifampicin (RIF).
INH and RIF were tested in 0.25 µg/mL and 0.5 µg/mL, respectively. The agar
proportion method was used as a reference method. MNRA and REMA were performed with
some modifications. MGDA and CVDA were performed as defined in the literature. The
agreements of the MNRA for INH and RIF were 96% and 94%, respectively, while the
agreement of the other assays for INH and RIF were 98%. In this study, while the
specificities of the REMA, MGDA and CVDA were 100%, the specificity of the MNRA was
lower than the others (93.3% for INH and 90.9% for RIF). In addition, while the
sensitivity of the MNRA was 100%, the sensitivities of the others were lower than
that of the MNRA (from 94.1-95%). The results were reported on the seventh-10th day
of the incubation. All methods are reliable, easy to perform, inexpensive and easy to
evaluate and do not require special equipment. 相似文献
3.
Background
The purpose of this study was to evaluate the performance of the BACTEC MGIT 960 (M960) system compared with the proportion method (PM) on Löwenstein-Jensen (L-J) medium in a peripheral laboratory in China for the testing of Mycobacterium tuberculosis (MTB) susceptibility to streptomycin (SM), isoniazid (INH) rifampicin (RIF) and ethambutol (EMB) a combination known as SIRE.Methods
The susceptibility of 205 clinical isolates of MTB to SM, INH, RIF and EMB was performed with the M960 system. The drugs were tested at the following concentrations: 1.0 µg/ml for SM, 0.1 µg/ml for INH, 1.0 µg/ml for RIF, and 5.0 µg/ml for EMB. The results were compared with those obtained by the L-J PM. The L-J PM at an arbiter site was used to resolve any discordant results.Results
The overall consistency was 96.6% and concordance values were 95.6% for SM, 97.6% for INH, 98.0% for RIF and 95.1% for EMB. The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the M960 system for PM (the standard method) was 95.6%, 97.3%, 96.2% and 96.9% respectively, and the sensitivity were 93.3% for SM, 96.9% for INH, 97.4% for RIF and 94.6% for EMB, the specificity were 96.9% for SM, 98.2% for INH, 98.4% for RIF and 95.5% for EMB, the PPV were 94.6% for SM, 97.9% for INH, 97.4% for RIF and 94.6% for EMB, the NPV were 96.2% for SM, 97.3% for INH, 98.4% for RIF and 95.5% for EMB. The turnaround time with the M960 system (median 8.0 days, ranged from 5 to 14 days) was significantly shorter than that with the PM (28 days or 42 days).Conclusion
There was a substantial degree of agreement between the two methods. The M960 system was a reliable and rapid method for SIRE susceptibility testing of tuberculosis in China. 相似文献4.
Sergio Luiz Montego Ferreira Junior Elis Regina Dalla Costa Paula Gon?alves dos Santos Harrison Magdinier Gomes Marcia Susana Nunes Silva Leonardo Souza Esteves Martha Maria Oliveira Raquel de Abreu Maschmann Afranio Lineu Kritski Philip Noel Suffys Maria Lucia Rosa Rossetti 《Memórias do Instituto Oswaldo Cruz》2014,109(3):307-314
Drug-resistant tuberculosis (TB) threatens global TB control and is a major public
health concern in several countries. We therefore developed a multiplex assay
(LINE-TB/MDR) that is able to identify the most frequent mutations related to
rifampicin (RMP) and isoniazid (INH) resistance. The assay is based on multiplex
polymerase chain reaction, membrane hybridisation and colorimetric detection
targeting of rpoB and katG genes, as well as the
inhA promoter, which are all known to carry specific mutations
associated with multidrug-resistant TB (MDR-TB). The assay was validated on a
reference panel of 108 M. tuberculosis isolates that were characterised by the
proportion method and by DNA sequencing of the targets. When comparing the
performance of LINE-TB/MDR with DNA sequencing, the sensitivity, specificity and
agreement were 100%, 100% and 100%, respectively, for RMP and 77.6%, 90.6% and 88.9%,
respectively, for INH. Using drug sensibility testing as a reference standard, the
performance of LINE-TB/MDR regarding sensitivity, specificity and agreement was 100%,
100% and 100% (95%), respectively, for RMP and 77%, 100% and 88.7% (82.2-95.1),
respectively, for INH. LINE-TB/MDR was compared with GenoType MTBDRplus for 65
isolates, resulting in an agreement of 93.6% (86.7-97.5) for RIF and 87.4%
(84.3-96.2) for INH. LINE-TB/MDR warrants further clinical validation and may be an
affordable alternative for MDR-TB diagnosis. 相似文献
5.
Guilian Li Jingrui Zhang Qian Guo Yi Jiang Jianhao Wei Li-li Zhao Xiuqin Zhao Jianxin Lu Kanglin Wan 《PloS one》2015,10(2)
Isoniazid (INH) and rifampicin (RIF) are the two most effective drugs in tuberculosis therapy. Understanding the molecular mechanisms of resistance to these two drugs is essential to quickly diagnose multidrug-resistant (MDR) tuberculosis and extensive drug-resistant tuberculosis. Nine clinical Mycobacterium tuberculosis isolates resistant to only INH and RIF and 10 clinical pan-sensitive isolates were included to evaluate the expression of 20 putative drug efflux pump genes and sequence mutations in rpoB (RIF), katG (INH), the inhA promoter (INH), and oxyR-ahpC (INH). Nine and three MDR isolates were induced to overexpress efflux pump genes by INH and RIF, respectively. Eight and two efflux pump genes were induced to overexpress by INH and RIF in MDR isolates, respectively. drrA, drrB, efpA, jefA (Rv2459), mmr, Rv0849, Rv1634, and Rv1250 were overexpressed under INH or RIF stress. Most efflux pump genes were overexpressed under INH stress in a MDR isolates that carried the wild-type katG, inhA, and oxyR-ahpC associated with INH resistance than in those that carried mutations. The expression levels of 11 genes (efpA, Rv0849, Rv1250, P55 (Rv1410c), Rv1634, Rv2994, stp, Rv2459, pstB, drrA, and drrB) without drug inducement were significantly higher (P < 0.05) in nine MDR isolates than in 10 pan-sensitive isolates. In conclusion, efflux pumps may play an important role in INH acquired resistance in MDR M. tuberculosis, especially in those strains having no mutations in genes associated with INH resistance; basal expression levels of some efflux pump genes are higher in MDR isolates than in pan-sensitive isolates and the basal expressional differences may be helpful to diagnose and treat resistant tuberculosis. 相似文献
6.
Nakwon Kwak Sun Mi Choi Jinwoo Lee Young Sik Park Chang-Hoon Lee Sang-Min Lee Chul-Gyu Yoo Young Whan Kim Sung Koo Han Jae-Joon Yim 《PloS one》2013,8(10)
The Xpert MTB/RIF assay was introduced for timely and accurate detection of tuberculosis (TB). The aim of this study was to determine the diagnostic accuracy and turnaround time (TAT) of Xpert MTB/RIF assay in clinical practice in South Korea. We retrospectively reviewed the medical records of patients in whom Xpert MTB/RIF assay using sputum were requested. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of pulmonary tuberculosis (PTB) and detection of rifampicin resistance were calculated. In addition, TAT of Xpert MTB/RIF assay was compared with those of other tests. Total 681 patients in whom Xpert MTB/RIF assay was requested were included in the analysis. The sensitivity, specificity, PPV and NPV of Xpert MTB/RIF assay for diagnosis of PTB were 79.5% (124/156), 100.0% (505/505), 100.0% (124/124) and 94.0% (505/537), respectively. Those for the detection of rifampicin resistance were 57.1% (8/14), 100.0% (113/113), 100.0% (8/8) and 94.9% (113/119), respectively. The median TAT of Xpert MTB/RIF assay to the report of results and results confirmed by physicians in outpatient settings were 0 (0–1) and 6 (3–7) days, respectively. Median time to treatment after initial evaluation was 7 (4–9) days in patients with Xpert MTB/RIF assay, but was 21 (7–33.5) days in patients without Xpert MTB/RIF assay. Xpert MTB/RIF assay showed acceptable sensitivity and excellent specificity for the diagnosis of PTB and detection of rifampicin resistance in areas with intermediate TB burden. Additionally, the assay decreased time to the initiation of anti-TB drugs through shorter TAT. 相似文献
7.
Cheng X Zhang J Yang L Xu X Liu J Yu W Su M Hao X 《Journal of microbiological methods》2007,70(2):301-305
Prompt detection of drug resistance in Mycobacterium tuberculosis is essential for effective control of tuberculosis (TB). We developed a Multi-PCR-SSCP method that detects more than 80% commonly observed isoniazid (INH) and rifampin (RIF) resistance M. tuberculosis in a single assay. The usefulness of the newly developed method was evaluated with 116 clinical isolates of M. tuberculosis. Distinct SSCP patterns were observed for different mutations and the correlation between Multi-PCR-SSCP results and DNA sequencing data was strong. Using the culture-based phenotypic drug susceptibility testing as a reference, the sensitivity of the newly developed Multi-PCR-SSCP assay was determined to be 80% and 81.8% for INH and RIF, respectively. The specificity of the assay was 100% and 92%, for INH and RIF, respectively. Multi-PCR-SSCP provides a rapid and potentially more cost-effective method of detecting multidrug-resistant TB. 相似文献
8.
Coban AY Cayci YT Deveci A Akgunes A Uzun M Durupinar B 《Memórias do Instituto Oswaldo Cruz》2011,106(3):378-380
The susceptibility of 49 Mycobacterium tuberculosis clinical isolates to isoniazid (INH) and rifampisin (RIF) (28 multi-drug resistant-tuberculosis samples) was determined by a nitrate reductase assay (NRA) on blood agar. Agreement between the NRA and other testing methods was found to be 93.8% for both INH and RIF. The sensitivity, specificity, positive predictive value and negative predictive value for INH were 92.8%, 94.2%, 86.6% and 97%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value for RIF were 90.4%, 96.4%, 95% and 93.1%. In conclusion, we show here that blood agar can be used effectively for the NRA test. 相似文献
9.
Fernanda de Oliveira Demitto Renata Claro Ribeiro do Amaral Flaviane Granero Maltempe Vera Lúcia Dias Siqueira Regiane Bertin de Lima Scodro Mariana Aparecida Lopes Katiany R. Caleffi-Ferracioli Pedro Henrique Canezin Rosilene Fressatti Cardoso 《PloS one》2015,10(2)
The aim of the present study was to evaluate the effect of the combination of rifampicin (RIF) and verapamil (VP) against the Mycobacterium tuberculosis H37Rv reference strain and six multidrug-resistant (MDR) M. tuberculosis clinical isolates by determining Time-Kill Curves and the ability to efflux drug by fluorometry. The RIF+VP combination showed synergism in one MDR clinical isolate. For the other five MDR clinical isolates, the drug combination showed no interaction. The MDR clinical isolate had lower ethidium bromide (EtBr) accumulation when exposed to the RIF+VP combination, compared with RIF and VP exposure alone. The other MDR clinical isolates showed no significant difference in EtBr accumulation. These results suggest greater efflux action in one of the MDR clinical isolates compared with the M. tuberculosis H37Rv reference strain. The other five MDR isolates may have additional mechanisms of drug resistance to RIF. The use of the RIF+VP combination made one MDR bacillus more susceptible to RIF probably by inhibiting efflux pumps, and this combination therapy, in some cases, may contribute to a reduction of resistance to RIF in M. tuberculosis. 相似文献
10.
The microplate nitrate reductase assay (MNRA) and the rezasurin microtitre assay (REMA) were used for the susceptibility testing of 73 clinical isolates and the results were compared with those that were obtained using the Bactec 460 TB and Bactec MGIT 960 systems. The REMA and the MNRA were performed in 96-well plates. For the REMA, the concentrations of isoniazid (INH) and rifampicin (RIF) ranged from 1.0-0.01 μg/mL and 2.0-0.03 μg/mL, respectively. For the MNRA, the INH concentration was between 1.0-0.03 μg/mL and the RIF concentration was between 2.0-0.06 μg/mL. For the MNRA, the sensitivity, specificity, positive predictive value, negative predictive value and INH/RIF agreement were 100/95.6, 97.6/100, 96.8/100, 100/98 and 98.6/98.6, respectively, and for the REMA, they were 100/91.3, 90.4/100, 88.5/100, 100/96.1 and 94.5/97.2, respectively. Our data suggest that these two rapid, low-cost methods may be inexpensive, alternative assays for the rapid detection of multidrug resistant tuberculosis in low-income countries. 相似文献
11.
Roberto Zenteno-Cuevas Francisco X Silva-Hernández Fabiola Mendoza-Damián Maria Dolores Ramírez-Hernández Karen Vázquez-Medina Lorena Widrobo-García Aremy Cuellar-Sanchez Raquel Mu?íz-Salazar Leonor Enciso-Moreno Lucia Monserrat Pérez-Navarro José Antonio Enciso-Moreno 《Memórias do Instituto Oswaldo Cruz》2013,108(6):718-723
Tuberculosis (TB) is an infectocontagious respiratory disease caused by members
of the Mycobacterium tuberculosis complex. A 7 base pair (bp)
deletion in the locus polyketide synthase
(pks)15/1 is described as polymorphic among members of the
M. tuberculosis complex, enabling the identification of
Euro-American, Indo-Oceanic and Asian lineages. The aim of this study was to
characterise this locus in TB isolates from Mexico. One hundred
twenty clinical isolates were recovered from the states of Veracruz and Estado
de Mexico. We determined the nucleotide sequence of a ± 400 bp fragment of the
locus pks15/1, while genotypic characterisation was
performed by spoligotyping. One hundred and fifty isolates contained the 7 bp
deletion, while five had the wild type locus. Lineages X (22%),
LAM (18%) and T (17%) were the most frequent; only three (2%) of the isolates
were identified as Beijing and two (1%) EAI-Manila. The wild type
pks15/1 locus was observed in all Asian lineage isolates
tested. Our results confirm the utility of locus pks15/1 as a
molecular marker for identifying Asian lineages of the M.
tuberculosis complex. This marker could be of great value in the
epidemiological surveillance of TB, especially in countries like Mexico, where
the prevalence of such lineages is unknown. 相似文献
12.
Freixo MI Caldas PC Said A Martins F Brito RC Fonseca Lde S Saad MH 《Memórias do Instituto Oswaldo Cruz》2004,99(1):107-110
Mycobacterium tuberculosis strains resistant to streptomycin (SM), isoniazid (INH), and/or rifampin (RIF) as determined by the conventional L?wenstein-Jensen proportion method (LJPM) were compared with the E test, a minimum inhibitory concentration susceptibility method. Discrepant isolates were further evaluated by BACTEC and by DNA sequence analyses for mutations in genes most often associated with resistance to these drugs (rpsL, katG, inhA, and rpoB). Preliminary discordant E test results were seen in 75% of isolates resistant to SM and in 11% to INH. Discordance improved for these two drugs (63%) for SM and none for INH when isolates were re-tested but worsened for RIF (30%). Despite good agreement between phenotypic results and sequencing analyses, wild type profiles were detected on resistant strains mainly for SM and INH. It should be aware that susceptible isolates according to molecular methods might contain other mechanisms of resistance. Although reproducibility of the LJPM susceptibility method has been established, variable E test results for some M. tuberculosis isolates poses questions regarding its reproducibility particularly the impact of E test performance which may vary among laboratories despite adherence to recommended protocols. Further studies must be done to enlarge the evaluated samples and looked possible mutations outside of the hot spot sequenced gene among discrepant strains. 相似文献
13.
Luz Maira Wintaco Martínez Gloria Puerto Castro Martha Inírida Guerrero 《Memórias do Instituto Oswaldo Cruz》2016,111(2):93-100
Developing a fast, inexpensive, and specific test that reflects the mutations present
in Mycobacterium tuberculosis isolates according to geographic
region is the main challenge for drug-resistant tuberculosis (TB) control. The
objective of this study was to develop a molecular platform to make a rapid diagnosis
of multidrug-resistant (MDR) and extensively drug-resistant TB based on single
nucleotide polymorphism (SNP) mutations present in therpoB,
katG, inhA,ahpC, and
gyrA genes from Colombian M. tuberculosis
isolates. The amplification and sequencing of each target gene was performed. Capture
oligonucleotides, which were tested before being used with isolates to assess the
performance, were designed for wild type and mutated codons, and the platform was
standardised based on the reverse hybridisation principle. This method was tested on
DNA samples extracted from clinical isolates from 160 Colombian patients who were
previously phenotypically and genotypically characterised as having susceptible or
MDR M. tuberculosis. For our method, the kappa index of the
sequencing results was 0,966, 0,825, 0,766, 0,740, and 0,625
forrpoB, katG,
inhA,ahpC, and gyrA,
respectively. Sensitivity and specificity were ranked between 90-100% compared with
those of phenotypic drug susceptibility testing. Our assay helps to pave the way for
implementation locally and for specifically adapted methods that can simultaneously
detect drug resistance mutations to first and second-line drugs within a few
hours. 相似文献
14.
A novel in situ loop-mediated isothermal amplification (in situ LAMP) technique for rapid detection of the food-borne Vibrio parahaemolyticus strains had been developed and evaluated in this study. The sensitivity of the in situ LAMP assay was detected to be 10 CFU/reaction via test in serial 10-fold dilutions of V. parahaemolyticus cells, and high specificity had also been obtained through confirmation with 14 reference gram-positive and -negative strains. Application of the established in situ LAMP assay had been performed on 58 strains previously isolated from seafood samples, including 48 V. parahaemolyticus and 10 non-V. parahaemolyticus strains. Of 48 V. parahaemolyticus strains, 48, 45 and 34 strains were detected as positive by in situ LAMP, regular LAMP and PCR, respectively, with the detection rate and negative predictive value (NPV) found to be 100% vs 93.8% vs 70.8% and 100% vs 76.9% vs 41.7%. In addition, none of the tested non-V. parahaemolyticus strains showed positive result, indicating a 100% positive predictive value (PPV) for all of 3 assays. Compared with regular LAMP methods and PCR-based methods, the in situ LAMP assay is advantageous on rapidity, high specificity, less time consumption and ease in operation, and may provide a novel, useful and practical detection platform for pathogens in food safety laboratories. 相似文献
15.
Sarah Sengstake Nino Bablishvili Anja Schuitema Nino Bzekalava Edgar Abadia Jessica de Beer Nona Tadumadze Maka Akhalaia Kiki Tuin Nestani Tukvadze Rusudan Aspindzelashvili Elizabeta Bachiyska Stefan Panaiotov Christophe Sola Dick van Soolingen Paul Klatser Richard Anthony Indra Bergval 《BMC genomics》2014,15(1)
Background
Multiplex ligation-dependent probe amplification (MLPA) is a powerful tool to identify genomic polymorphisms. We have previously developed a single nucleotide polymorphism (SNP) and large sequence polymorphisms (LSP)-based MLPA assay using a read out on a liquid bead array to screen for 47 genetic markers in the Mycobacterium tuberculosis genome. In our assay we obtain information regarding the Mycobacterium tuberculosis lineage and drug resistance simultaneously. Previously we called the presence or absence of a genotypic marker based on a threshold signal level. Here we present a more elaborate data analysis method to standardize and streamline the interpretation of data generated by MLPA. The new data analysis method also identifies intermediate signals in addition to classification of signals as positive and negative. Intermediate calls can be informative with respect to identifying the simultaneous presence of sensitive and resistant alleles or infection with multiple different Mycobacterium tuberculosis strains.Results
To validate our analysis method 100 DNA isolates of Mycobacterium tuberculosis extracted from cultured patient material collected at the National TB Reference Laboratory of the National Center for Tuberculosis and Lung Diseases in Tbilisi, Republic of Georgia were tested by MLPA. The data generated were interpreted blindly and then compared to results obtained by reference methods. MLPA profiles containing intermediate calls are flagged for expert review whereas the majority of profiles, not containing intermediate calls, were called automatically. No intermediate signals were identified in 74/100 isolates and in the remaining 26 isolates at least one genetic marker produced an intermediate signal.Conclusion
Based on excellent agreement with the reference methods we conclude that the new data analysis method performed well. The streamlined data processing and standardized data interpretation allows the comparison of the Mycobacterium tuberculosis MLPA results between different experiments. All together this will facilitate the implementation of the MLPA assay in different settings.Electronic supplementary material
The online version of this article (doi:10.1186/1471-2164-15-572) contains supplementary material, which is available to authorized users. 相似文献16.
Marie Sylvianne Rabodoarivelo Bélen Imperiale Rina andrianiavomikotroka Angela Brandao Parveen Kumar Sarman Singh Lucilaine Ferrazoli Nora Morcillo Voahangy Rasolofo Juan Carlos Palomino Peter Vandamme Anandi Martin 《PloS one》2015,10(10)
Background
Detection of drug-resistant tuberculosis is essential for the control of the disease but it is often hampered by the limitation of transport and storage of samples from remote locations to the reference laboratory. We performed a retrospective field study to evaluate the performance of four supports enabling the transport and storage of samples to be used for molecular detection of drug resistance using the GenoType MTBDRplus.Methods
Two hundred Mycobacterium tuberculosis strains were selected and spotted on slides, FTA cards, GenoCards, and in ethanol. GenoType MTBDRplus was subsequently performed with the DNA extracted from these supports. Sensitivity and specificity were calculated and compared to the results obtained by drug susceptibility testing.Results
For all supports, the overall sensitivity and specificity for detection of resistance to RIF was between 95% and 100%, and for INH between 95% and 98%.Conclusion
The four transport and storage supports showed a good sensitivity and specificity for the detection of resistance to RIF and INH in M. tuberculosis strains using the GenoType MTBDRplus. These supports can be maintained at room temperature and could represent an important alternative cost-effective method useful for rapid molecular detection of drug-resistant TB in low-resource settings. 相似文献17.
Bergval I Kwok B Schuitema A Kremer K van Soolingen D Klatser P Anthony R 《PloS one》2012,7(1):e29108
Both the probability of a mutation occurring and the ability of the mutant to persist will influence the distribution of mutants that arise in a population. We studied the interaction of these factors for the in vitro selection of rifampicin (RIF)-resistant mutants of Mycobacterium tuberculosis. We characterised two series of spontaneous RIF-resistant in vitro mutants from isoniazid (INH)-sensitive and -resistant laboratory strains and clinical isolates, representing various M. tuberculosis genotypes. The first series were selected from multiple parallel 1 ml cultures and the second from single 10 ml cultures. RIF-resistant mutants were screened by Multiplex Ligation-dependent Probe Amplification (MLPA) or by sequencing the rpoB gene. For all strains the mutation rate for RIF resistance was determined with a fluctuation assay. The most striking observation was a shift towards rpoB-S531L (TCG→TTG) mutations in a panel of laboratory-generated INH-resistant mutants selected from the 10-ml cultures (p<0.001). All tested strains showed similar mutation rates (1.33×10−8 to 2.49×10−7) except one of the laboratory-generated INH mutants with a mutation rate measured at 5.71×10−7, more than 10 times higher than that of the INH susceptible parental strain (5.46–7.44×10−8). No significant, systematic difference in the spectrum of rpoB-mutations between strains of different genotypes was observed. The dramatic shift towards rpoB-S531L in our INH-resistant laboratory mutants suggests that the relative fitness of resistant mutants can dramatically impact the distribution of (subsequent) mutations that accumulate in a M. tuberculosis population, at least in vitro. We conclude that, against specific genetic backgrounds, certain resistance mutations are particularly likely to spread. Molecular screening for these (combinations of) mutations in clinical isolates could rapidly identify these particular pathogenic strains. We therefore recommend that isolates are screened for the distribution of resistance mutations, especially in regions that are highly endemic for (multi)drug resistant tuberculosis. 相似文献
18.
Background
Drug resistant tuberculosis (TB) is a growing concern worldwide. Early detection of multidrug-resistant Mycobacterium tuberculosis is of primary importance for both patient management and infection control. Optimal method for identifying drug-resistant M. tuberculosis in a timely and affordable way in resource-limited settings is not yet available.Aim
This study evaluated; nitrate reductase assay (NRA), resazurin microtiter assay (REMA) and microscopic observation drug susceptibility assay (MODS) against the conventional 1% proportion method (PM) for the detection of resistance to first line antitubercular drugs, in M. tuberculosis clinical isolates.Methods
A total of one hundred and five clinical isolates of M. tuberculosis; 50 pan sensitive and 55 pan resistant were tested with NRA, REMA and MODS. The 1% proportion method on Lowenstein-Jensen medium was used as reference test.Results
Of all three methods which were tested NRA was found to be most sensitive and specific. Sensitivity for rifampicin resistance detection was 100%, 94.55% and 92.73% by NRA, REMA and MODS respectively. NRA and REMA were found to be 100% specific, while the MODS was 98% specific for detection of rifampicin resistance. Test results with all these methods were obtained within 8-14 days.Conclusion
Rapid non-conventional and inexpensive methods may serve as a replacement for 1% proportion method in resource limited settings. 相似文献19.
Yacoob Mahomed Coovadia Sharana Mahomed Melendhran Pillay Lise Werner Koleka Mlisana 《PloS one》2013,8(11)
Setting
The dual epidemics of HIV-TB including MDR-TB are major contributors to high morbidity and mortality rates in South Africa. Rifampicin (RIF) resistance is regarded as a proxy for MDR-TB. Currently available molecular assays have the advantage of rapidly detecting resistant strains of MTB, but the GeneXpert does not detect isoniazid (INH) resistance and the GenoTypeMTBDRplus(LPA) assay may underestimate resistance to INH. Increasing proportions of rifampicin mono-resistance resistance (RMR) have recently been reported from South Africa and other countries.Objective
This laboratory based study was conducted at NHLS TB Laboratory, Durban, which is the reference laboratory for culture and susceptibility testing in KwaZulu-Natal. We retrospectively determined, for the period 2007 to 2009, the proportion of RMR amongst Mycobacterium tuberculosis (MTB) isolates, that were tested for both RIF and INH, using the gold standard of culture based phenotypic drug susceptibility testing (DST). Gender and age were also analysed to identify possible risk factors for RMR.Design
MTB culture positive sputum samples from 16,748 patients were analysed for susceptibility to RIF and INH during the period 2007 to 2009. RMR was defined as MTB resistant to RIF and susceptible to INH. For the purposes of this study, only the first specimen from each patient was included in the analysis.Results
RMR was observed throughout the study period. The proportion of RMR varied from a low of 7.3% to a high of 10.0% [overall 8.8%]. Overall, males had a 42% increased odds of being RMR as compared to females. In comparison to the 50 plus age group, RMR was 37% more likely to occur in the 25–29 year age category.Conclusion
We report higher proportions of RMR ranging from 7.3% to 10% [overall 8.8%] than previously reported in the literature. To avoid misclassification of RMR, detected by the GeneXpert, as MDR-TB, culture based phenotypic DST must be performed on a second specimen, as recommended by the SA NDOH TB guidelines as well as WHO. We suggest that two sputum samples should be obtained at the first visit. The second sputum sample should be stored at 4°C. The latter sample is then readily available for performing additional DST (phenotypic or genotypic) for 2nd lines drugs, resulting in a decreased waiting period for DST results to become available. 相似文献20.
Luiza Pinheiro Carla Ivo Brito Valéria Cataneli Pereira Adilson de Oliveira Carlos Henrique Camargo Maria de Lourdes Ribeiro de Souza da Cunha 《Memórias do Instituto Oswaldo Cruz》2014,109(7):871-878
This study aimed to correlate the presence of ica genes, biofilm
formation and antimicrobial resistance in 107 strains of Staphylococcus
epidermidis isolated from blood cultures. The isolates were analysed to
determine their methicillin resistance, staphylococcal cassette chromosome
mec (SCCmec) type, ica genes
and biofilm formation and the vancomycin minimum inhibitory concentration (MIC) was
measured for isolates and subpopulations growing on vancomycin screen agar. The
mecA gene was detected in 81.3% of the S.
epidermidis isolated and 48.2% carried SCCmec type III.
The complete icaADBC operon was observed in 38.3% of the isolates;
of these, 58.5% produced a biofilm. Furthermore, 47.7% of the isolates grew on
vancomycin screen agar, with an increase in the MIC in 75.9% of the isolates.
Determination of the MIC of subpopulations revealed that 64.7% had an MIC ≥ 4 μg
mL-1, including 15.7% with an MIC of 8 μg mL-1 and 2% with
an MIC of 16 μg mL-1. The presence of the icaADBC operon,
biofilm production and reduced susceptibility to vancomycin were associated with
methicillin resistance. This study reveals a high level of methicillin resistance,
biofilm formation and reduced susceptibility to vancomycin in subpopulations of
S. epidermidis. These findings may explain the selection of
multidrug-resistant isolates in hospital settings and the consequent failure of
antimicrobial treatment. 相似文献