Evaluation of the GenoType MTBDRplus and MTBDRsl for the detection of drug-resistant Mycobacterium tuberculosis on isolates from Beijing, China.

Abstract

BackgroundThe incidence of tuberculosis (TB), especially multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB), continues to increase alarmingly worldwide. Molecular line probe assays (LPAs) are endorsed by the World Health Organization for the fast detection of MDR-TB and XDR-TB. The aim of this study was to evaluate the performance of LPAs in China.MethodsWe analyzed MDR-TB and XDR-TB in 96 isolates from Beijing by using culture-based drug susceptibility testing (DST) and LPAs to compare the detection rate of the two methods.ResultsCompared to phenotypic DST, the GenoType® MTBDRplus and MTBDRsl, respectively, showed a sensitivity of 98.7% and a specificity of 88.9% for detection of rifampicin resistance, 82.1% and 94.4% for isoniazid, 89.7% and 94.4% for levofloxacin, 60.0% and 98.7% for amikacin/capreomycin, and 57.5% and 98.2% for ethambutol. The sensitivity and specificity of LPAs, respectively, were 80.8% and 100% for MDR-TB and 50.0% and 97.6% for XDR-TB. Mutations in codon S531L of the rpoB gene and S315T1 of the KatG gene were dominated in MDR-TB strains. The most frequently observed mutations were in codon A90V of the gyrA gene, A1401G of the rrs gene, and M306V of the embB gene, according to the MTBDRsl results.ConclusionOur study showed that, in combination with phenotypic DST, application of the LPAs might be an efficient and reliable supplementary DST assay for rapid susceptibility screening of MDR-TB and XDR-TB. Using LPAs in countries with high MDR/XDR burden allows for appropriate and timely treatment, which will reduce transmission rates and morbidity, and improve treatment outcomes in patients.