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Combination of commercially available molecular assays and culture based methods in diagnosis of tuberculosis and drug resistant tuberculosis.

Authors
  • Gkaravela, Lamprini1
  • Papadimitriou-Olivgeris, Matthaios2
  • Foka, Antigoni1
  • Kolonitsiou, Fevronia1
  • Spiliopoulou, Anastasia1
  • Charokopos, Nikolaos3
  • Voulgaridis, Apostolos4
  • Tsiamita, Maria4
  • Marangos, Markos2
  • Anastassiou, Evangelos D1
  • Spiliopoulou, Iris5
  • 1 Department of Microbiology, School of Medicine, University of Patras, Rion, Patras, Greece. , (Greece)
  • 2 Division of Infectious Diseases, School of Medicine, University of Patras, Rion, Patras, Greece. , (Greece)
  • 3 Department of Pulmonology, Regional General Hospital of Pirgos, Pirgos, Greece. , (Greece)
  • 4 Department of Pulmonology, University General Hospital of Patras, Rion, Patras, Greece. , (Greece)
  • 5 Department of Microbiology, School of Medicine, University of Patras, Rion, Patras, Greece. Electronic address: [email protected] , (Greece)
Type
Published Article
Journal
Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology]
Publication Date
Jan 01, 2017
Volume
48
Issue
4
Pages
785–790
Identifiers
DOI: 10.1016/j.bjm.2017.04.001
PMID: 28689813
Source
Medline
Keywords
License
Unknown

Abstract

Early diagnosis of tuberculosis is of major clinical importance. Among 4733 clinical specimens collected from 3363 patients and subjected to Ziehl-Neelsen microscopy, 4109 were inoculated onto Löwenstein-Jensen slants and 3139 in Bactec/9000MB. Polymerase Chain Reaction (PCR) was performed in 3139 specimens, whereas, a genotypic assay was directly applied in 93 Mycobacterium tuberculosis complex PCR-positive for isoniazid and rifampicin resistance detection specimens (GenoType MTBDRplus). Recovered M. tuberculosis isolates (64) as well as, 21 more sent from Regional Hospitals were tested for antimycobacterial resistance with a phenotypic (manual MGIT-SIRE) and a genotypic assay (GenoType MTBDRplus). PCR in the clinical specimens showed excellent specificity (97.4%) and accuracy (96.8%), good sensitivity (70.4%), but low positive predictive value (40.3%). MGIT-SIRE performed to M. tuberculosis did not confer a reliable result in 16 isolates. Of the remaining 69 isolates, 15 were resistant to streptomycin, seven to isoniazid, seven to ethambutol and five to rifampicin. GenoType MTBDRplus correctly detected isoniazid (seven) and rifampicin-resistant M. tuberculosis strains (five), showing an excellent performance overall (100%). Susceptibility results by the molecular assay applied directly to clinical specimens were identical to those obtained from recovered isolates of the corresponding patients. Combining molecular and conventional methods greatly contribute to early diagnosis and accurate susceptibility testing of tuberculosis.

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