Application of Genotype MTBDRplus in rapid detection of the Mycobacterium tuberculosis complex as well as its resistance to isoniazid and rifampin in a high volum laboratory in Southern China |
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Authors: | Lei?Zhang Yuanxing?Ye Lina?Duo Tingting?Wang Xingbo?Song Xiaojun?Lu Email author" target="_blank">Binwu?YingEmail author Email author" target="_blank">Lanlan?WangEmail author |
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Institution: | (1) Department of Laboratory Medicine, West China Hospital of Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan Province, People’s Republic of China; |
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Abstract: | The alarmingly worsening epidemics of drug-resistant tuberculosis (TB) call urgent need for a simple method for the rapid
detection of drug-resistant TB in clinical settings. In an attempt to establish a rapid procedure for laboratory diagnosis
of TB and investigate the local TB epidemiology, molecular line probe assay of the Genotype MTBDRplus was used to identify
Mycobacterium tuberculosis complex (MTBC) and detect mutations conferring resistance to two most active first-line drugs against
TB: Rifampin and Isoniazid. 96 acid-fast bacillus (AFB) smear- positive sputums and 18 PCR-positive non-sputum specimens have
been determined for the MTBC and resistance to Rifampin and Isoniazid. The MTBC detection rates in two sources of specimens
were 93.8% (90/96) and 77.8% (14/18) respectively. The overall drug resistance (Rifampin or Isoniazid) occurred in 34.6% (36/104).
Resistance to rifampin (RMP) was 28.8% (30/104) and 25% (26/104) was to Isoniazid (INH), in which high level drug resistance
accounted for 88.5% (23/26) and low level drug resistance accounted for 7.7% (2/26). Multidrug resistance (MDR), defined as
resistant to both RMP and INH, was found in 19.2% (20/104) of clinical samples, which was double that of official statistics.
In addition, 63.3% (19/30) RMP-resistant mutations were identified in the region of RopB 530–533 and 57.9% (11/19) were the
S531L mutation. 84.6% (22/26) of resistance to INH was mediated by Kat S315T1 mutations which conferred the high-level resistance
to INH. The Genotype MTBDRplus line probe assay is a suitable and applicable method for establishing the rapidness in detection
of drug-resistant TB in clinical laboratory. It will be a valuable addition to the conventional TB diagnostic approaches. |
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