Detection of multidrug-resistant tuberculosis using MGIT™(TM) and MAS-PCR in Tripura, India

Int J Tuberc Lung Dis. 2016 Feb;20(2):166-9. doi: 10.5588/ijtld.14.0986.

Abstract

Background: Multidrug-resistant tuberculosis (MDR-TB) poses a global threat that is further compounded by the human immunodeficiency virus (HIV) epidemic.

Objective: To detect MDR-TB among pulmonary TB (PTB) patients with or without HIV coinfection by isolating and identifying Mycobacterium tuberculosis from clinical samples and performing drug susceptibility testing (DST).

Methods: Sputum was collected from presumed PTB cases. Microscopic examination was performed following Ziehl-Neelsen (ZN) staining and cultured in Löwenstein-Jensen (LJ) medium. First-line anti-tuberculosis DST of the isolates was performed using MGIT™ (Mycobacterial Growth Indicator Tube) and multiplex allele-specific polymerase chain reaction (MAS-PCR).

Results: Of 172 study subjects, 59.3% (102/172) were smear-positive and 40.7% (70/172) were smear-negative. In the smear-positive and -negative groups, respectively 62.7% (64/102) and 8.6% (6/70) were culture-positive. DST on MGIT showed a cumulative resistance of 7.1% (5/70) to isoniazid (INH) and rifampicin. More ethambutol (EMB) and combined INH+EMB resistance was detected using MAS-PCR.

Conclusion: MDR-TB is a problem in Tripura, and culture and phenotypic DST are required for diagnosis. MAS-PCR may provide an alternative rapid screening tool.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antitubercular Agents / therapeutic use
  • Coinfection
  • DNA, Bacterial / genetics*
  • Drug Resistance, Multiple, Bacterial / genetics
  • Female
  • Genotype
  • HIV Infections / diagnosis
  • HIV Infections / virology
  • Humans
  • India
  • Male
  • Microbial Sensitivity Tests*
  • Microscopy
  • Middle Aged
  • Molecular Diagnostic Techniques*
  • Multiplex Polymerase Chain Reaction*
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / genetics*
  • Mycobacterium tuberculosis / isolation & purification
  • Phenotype
  • Predictive Value of Tests
  • Sputum / microbiology
  • Tuberculosis, Multidrug-Resistant / diagnosis*
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / microbiology
  • Tuberculosis, Pulmonary / diagnosis*
  • Tuberculosis, Pulmonary / drug therapy
  • Tuberculosis, Pulmonary / microbiology
  • Young Adult

Substances

  • Antitubercular Agents
  • DNA, Bacterial