Department of Microbiology and Immunology, Ain Sham University, Faculty of Medicine, Cairo, Egypt.
Int J Tuberc Lung Dis. 2012 Jul;16(7):941-6. doi: 10.5588/ijtld.11.0547. Epub 2012 May 7.
Early detection of multidrug-resistant Mycobacterium tuberculosis (MDR-TB) is of primary importance for both patient management and infection control. Optimal methods for identifying MDR-TB in a timely and affordable manner in resource-limited settings are not yet available.
To evaluate the performance of a low-technology but rapid drug susceptibility testing method, the microscopic observation drug susceptibility assay (MODS), in the concurrent detection of M. tuberculosis and its susceptibility to isoniazid (INH) and rifampin (RMP) directly from sputum specimens.
A total of 115 smear-positive TB patients admitted to Abbasia Chest Hospital, Cairo, Egypt, were simultaneously tested using MODS and the BACTEC MGIT 960 mycobacterial detection system for the detection of M. tuberculosis and the identification of MDR-TB samples.
MODS detected 112 (97.4%) samples and BACTEC MGIT detected 115 (100%). Of the 115 isolates tested for susceptibility to INH, RMP and MDR-TB, complete agreement between MODS and MGIT results was found among respectively 92.9%, 95.5% and 97.3% of samples. The sensitivity, specificity, and positive and negative predictive values of MODS in the detection of MDR-TB were respectively 95.3%, 98.6%, 97.6% and 97.1%. MODS results were obtained in a median of 8 days (range 5-21).
MODS is an optimal alternative method for timely and affordable identification of MDR-TB in resource-limited settings.
早期发现耐多药结核分枝杆菌（MDR-TB）对患者管理和感染控制都至关重要。在资源有限的情况下，尚未找到能够及时且经济实惠地识别 MDR-TB 的最佳方法。
评估一种低技术但快速的药敏检测方法，即微量液基药敏试验（MODS），在同时检测痰标本中的结核分枝杆菌及其对异烟肼（INH）和利福平（RMP）的敏感性方面的性能。
共对 115 例埃及开罗阿巴西亚胸科医院的涂片阳性肺结核患者同时进行 MODS 和 BACTEC MGIT 960 分枝杆菌检测系统检测，以检测结核分枝杆菌和鉴定 MDR-TB 样本。
MODS 检测到 112 份（97.4%）样本，BACTEC MGIT 检测到 115 份（100%）。在对 115 株分离物进行 INH、RMP 和 MDR-TB 药敏试验时，MODS 与 MGIT 结果完全一致的比例分别为 92.9%、95.5%和 97.3%。MODS 检测 MDR-TB 的敏感性、特异性、阳性预测值和阴性预测值分别为 95.3%、98.6%、97.6%和 97.1%。MODS 结果的中位数为 8 天（范围 5-21）。
MODS 是一种在资源有限的情况下及时且经济实惠地识别 MDR-TB 的理想替代方法。
