Samara Oblast Tuberculosis Dispensary, Samara, Russia.
J Clin Microbiol. 2012 May;50(5):1593-7. doi: 10.1128/JCM.00039-12. Epub 2012 Feb 29.
The rate of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) has been steadily increasing in countries of the former USSR. The availability of rapid and reliable methods for the detection of drug resistance to second-line drugs is vital for adequate patient management. We evaluated the performance of the Genotype MTBDRsl assay compared to that of phenotypic drug susceptibility testing (Becton Dickinson Bactec MGIT 960 system) with a test panel of 200 Mycobacterium tuberculosis isolates at four sites in Eastern Europe. The interpretability of the Genotype MTBDRsl assay was over 95%. The sensitivity for the detection of resistance to fluoroquinolones, ethambutol, amikacin, and capreomycin varied between 77.3% and 92.3%; however, it was much lower for kanamycin (42.7%). The sensitivity for the detection of XDR TB was 22.6%. The test specificity was over 82% for all drugs. The assay presents a good screening tool for the rapid detection of resistance to individual second-line drugs and can be recommended for use in countries with a high burden of MDR/XDR TB. The sensitivity for the detection of kanamycin resistance needs improvement.
在前苏联国家，耐多药（MDR）和广泛耐药（XDR）结核病（TB）的发病率一直在稳步上升。快速可靠的二线药物耐药性检测方法的可用性对于患者的充分管理至关重要。我们评估了 Genotype MTBDRsl 检测与表型药敏试验（Becton Dickinson Bactec MGIT 960 系统）在东欧四个地点的 200 株结核分枝杆菌分离株的检测面板中的性能。Genotype MTBDRsl 检测的可解释性超过 95%。对氟喹诺酮类、乙胺丁醇、阿米卡星和卷曲霉素耐药性的检测敏感性在 77.3%至 92.3%之间；然而，对卡那霉素的敏感性要低得多（42.7%）。对 XDR TB 的检测敏感性为 22.6%。该检测对所有药物的特异性均超过 82%。该检测是一种快速检测二线药物耐药性的良好筛选工具，可推荐在前苏联国家广泛耐药/XDR TB 负担较高的国家使用。检测卡那霉素耐药性的敏感性需要提高。
