Use of a FluoroType® System for the Rapid Detection of Patients with Multidrug-Resistant Tuberculosis—State of the Art Case Presentations

Anna Zabost,Dorota Filipczak,Agnieszka Winiarska,Monika Szturmowicz,Włodzimierz Kupis,Łukasz Olendrzyński,Ewa Augustynowicz-Kopeć,Jacek Jagodziński

doi:10.3390/diagnostics12030711

Anna Zabost, Dorota Filipczak + Show 6 more

Open Access

https://doi.org/10.3390/diagnostics12030711

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Journal: Diagnostics	Publication Date: Mar 15, 2022
License type: CC BY 4.0

Affiliation: Masih Daneshvari Hospital

Abstract

According to the World Health Organization (WHO), there were 465,000 cases of tuberculosis caused by strains resistant to at least two first-line anti-tuberculosis drugs: rifampicin and isoniazid (MDR-TB). In light of the growing problem of drug resistance in Mycobacterium tuberculosis across laboratories worldwide, the rapid identification of drug-resistant strains of the Mycobacterium tuberculosis complex poses the greatest challenge. Progress in molecular biology and the development of nucleic acid amplification assays have paved the way for improvements to methods for the direct detection of Mycobacterium tuberculosis in specimens from patients. This paper presents two cases that illustrate the implementation of molecular tools in the recognition of drug-resistant tuberculosis.

Highlights

Tuberculosis, despite the considerable effort aimed at controlling its global spread, remains a public health challenge worldwide
The test confirmed the presence of the genetic material of Mycobacterium tuberculosis and identified, at the same time, the presence of the S315T1 mutation in the katG gene, which confers the resistance to isoniazid (INH)
The same analysis revealed that one year after treatment initiation, cases of INH mono-resistant tuberculosis had lower treatment success rates compared to cases with drug-susceptible tuberculosis (67.7% vs. 75.8%), which allowed the authors to hypothesize that INH mono-resistance negatively impacted the treatment outcomes

Summary

Introduction

Tuberculosis, despite the considerable effort aimed at controlling its global spread, remains a public health challenge worldwide. Progress in molecular biology and the development of nucleic acid amplification assays have paved the way for improvements to methods for the direct detection of Mycobacterium tuberculosis in specimens from patients These techniques make it possible to detect and identify the Mycobacterium tuberculosis complex at a higher sensitivity and within a shorter period of time compared to conventional methods, which is important in cases that are difficult to diagnose. Diagnostics 2022, 12, 711 terium tuberculosis and identified, at the same time, the presence of the S315T1 mutation in the katG gene, which confers the resistance to isoniazid (INH). The test confirmed the presence of the genetic material of Mycobacterium tuberculosis and identified, at the same time, the presence of the S315T1 mutation in the katG gene, which confers the resistance to isoniazid (INH). Fiduretnhteifryanmaulyltsiidsroufgdreusgisrteasnisctea.nFcueritnhtehreagnraolywsnissotrfadinr,uugsrinesgisthtaenGceeninoTthype egMroTwBnDsRtrsal ians,suays,‐ ailnlogwtheedGuesntoTcylapsesiMfyTtBhDe sRtsral ainssaasya, naleloxwteendsiuvesltyodclrausgs-irfeystihsteasnttra(XinDaRs)asntreaxinte.nAsimveolyledcurulagr‐ arneasilsytsains tb(aXsDedRo) nstrsapionl.igAomtyopliencguqlauraalinfiaeldystihsebsatsreadinotnostphoeliBgeoitjiynpgin1gmqoulaelciufileadr tfhame siltyr.aiTnhteo ptahteieBnetiwjinags a1dmiotltecdutloarthfeamtuiblye.rcTuhloespisaitniepnatiwenats dadepmairtttmedenttotothsetatrutbaeprpcruolporsiasteintphaetriaepnyts; ndeevpearrthtmeleensst,tsohsetadriteadp1p0rodparyisatleattehre. rapy; she died 10 days later

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Conclusions