Accuracy of molecular drug susceptibility testing amongst tuberculosis patients in Karakalpakstan, Uzbekistan
Objectives In this retrospective study, we evaluated the diagnostic accuracy of molecular tests (MT) for the detection of DR‐TB, compared to the gold standard liquid‐based drug susceptibility testing (DST) in Karakalpakstan. Methods A total of 6670 specimens received in the Republican TB No 1 Hospit...
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Published in | Tropical medicine & international health Vol. 26; no. 4; pp. 421 - 427 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
England
Blackwell Publishing Ltd
01.04.2021
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Subjects | |
Online Access | Get full text |
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Summary: | Objectives
In this retrospective study, we evaluated the diagnostic accuracy of molecular tests (MT) for the detection of DR‐TB, compared to the gold standard liquid‐based drug susceptibility testing (DST) in Karakalpakstan.
Methods
A total of 6670 specimens received in the Republican TB No 1 Hospital Laboratory of Karakalpakstan between January and July 2017 from new and retreatment patients were analysed. Samples were tested using Xpert MTB/RIF and line probe assays (LPA) for the detection of mutations associated with resistance. The sensitivity and specificity of MTs were calculated relative to results based on DST.
Results
The accuracy of MT for detection of rifampicin resistance was high, with sensitivity and specificity over 98%. However, we observed reduced sensitivity of LPA for detection of resistance; 86% for isoniazid (95% CI 82–90%), 86% for fluoroquinolones (95% CI 68‐96%), 70% for capreomycin (95% CI 46–88%) and 23% for kanamycin (95% CI 13–35%).
Conclusions
We show that MTs are a useful tool for rapid and safe diagnosis of DR‐TB; however, clinicians should be aware of their limitations. Although detection of rifampicin resistance was highly accurate, our data suggest that resistance mutations circulating in the Republic of Karakalpakstan for other drugs were not detected by the methods used here. This merits further investigation. |
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Bibliography: | 3.3 Sustainable Development Goals (SDGs) ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 |
ISSN: | 1360-2276 1365-3156 1365-3156 |
DOI: | 10.1111/tmi.13543 |