Abstract
Resistance to Mycobacterium tuberculosis is a reality worldwide, and its diagnosis continues to be difficult and time consuming. To face this challenge, the World Health Organization has recommended the use of rapid molecular tests. We evaluated the routine use (once a week) of a line probe assay (Genotype MTBDRplus) for early diagnosis of resistance and for assessment of the main related risk factors over 2 years. A total of 170 samples were tested: 15 (8.8%) were resistant, and multidrug resistance was detected in 10 (5.9%). The sensitivity profile took 3 weeks (2 weeks for culture and 1 week for rapid testing). Previous treatment for tuberculosis and the persistence of positive acid-fast smears after 4 months of supervised treatment were the major risk factors observed. The use of molecular tests enabled early diagnosis of drug-resistant bacilli and led to appropriate treatment of the disease. This information has the potential to interrupt the transmission chain of resistant M. tuberculosis.
Highlights
Brazil is among 22 countries that have a concentration of approximately 80% of all tuberculosis (TB) patients, and occupies the 16th position in absolute numbers of cases [1]
We evaluated the routine use of a line probe assay (Genotype MTBDRplus) for early diagnosis of resistance and for assessment of the main related risk factors over 2 years
The objective of this study was to evaluate the systematic use of an line probe assay (LPA) to diagnose resistance of M. tuberculosis and the potential meaning of this information in decision making for patients treated in a tertiary reference center in the State of São Paulo, Brazil
Summary
Brazil is among 22 countries that have a concentration of approximately 80% of all tuberculosis (TB) patients, and occupies the 16th position in absolute numbers of cases [1]. The bacillary resistance is still rarely diagnosed, mainly due to the low access to sensitivity tests in countries with greater incidences of the disease [1,4] This is related to the scarcity of available data on the epidemiology of resistance, as evidenced in Brazil [3,5]. Among them is the Genotype MTBDRplus (Hain Lifescience, Germany) line probe assay (LPA), approved for use with specimens growing in culture media and for use with smear-positive sputum samples This test identifies M. tuberculosis complex bacilli and detects mutations in three genes: rpoB, which confers resistance to rifampicin; KatG, which confers high-level resistance to isoniazid; and the inhA regulatory region, which confers low-level resistance to isoniazid [8]
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Schedule a callMore From: Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas
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