Evaluation of the GenoType(®) MTBDRplus line probe assay on sputum-positive samples in routine settings in China

Int J Tuberc Lung Dis. 2014 Sep;18(9):1034-9. doi: 10.5588/ijtld.13.0857.

Abstract

Background: Rapid molecular methods have been recommended for early detection of drug-resistant tuberculosis (TB).

Objective: To evaluate the performance of the GenoType(®) MTBDRplus assay in routine settings in China.

Methods: Sputum-positive samples were collected consecutively from 1 April to 31 December 2010. MTBDRplus results were compared to those of conventional drug susceptibility testing (DST). The McNemar χ(2) test and κ coefficient were used to assess performance.

Results: Of 427 smear-positive sputum samples collected, conventional DST and MTBDTplus confirmed drug resistance in 326. The sensitivities and specificities for MTBDRplus in detecting isoniazid (INH) and rifampicin (RMP) resistance were respectively 76.47%, 95.44%, 85.94% and 93.13%. The McNemar χ(2) test indicated no significant difference between the two methods (P = 0.106 for INH and P = 0.083 for RMP). The κ values for INH, RMP and multidrug resistance were respectively 0.75, 0.75 and 0.70.

Conclusions: Although the MTBDRplus assay was moderately concordant with conventional DST in detecting INH and RMP resistance, as a prospective rapid molecular method for MDR-TB detection, potential resistant mutations need to be incorporated to improve the accuracy of detection.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antitubercular Agents / therapeutic use
  • Bacteriological Techniques*
  • Chi-Square Distribution
  • China
  • DNA Mutational Analysis*
  • DNA, Bacterial / isolation & purification*
  • Drug Resistance, Multiple, Bacterial / genetics
  • Early Diagnosis
  • Humans
  • Isoniazid / therapeutic use
  • Microbial Sensitivity Tests
  • Molecular Diagnostic Techniques*
  • Mutation
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / genetics
  • Mycobacterium tuberculosis / isolation & purification*
  • Predictive Value of Tests
  • Prognosis
  • Reproducibility of Results
  • Rifampin / therapeutic use
  • 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

Substances

  • Antitubercular Agents
  • DNA, Bacterial
  • Isoniazid
  • Rifampin