Comparison between the BACTEC MGIT 960 system and the agar proportion method for susceptibility testing of multidrug resistant tuberculosis strains in a high burden setting of South Africa

BMC Infectious Diseases

Marthie M Ehlers¹  Anwar A Hoosen¹  Ayman G Osman²  Shaheed V Omar²  Kamaldeen Baba¹  Nazir A Ismail¹  Marleen M Kock¹  Halima M Said² 

[1] National Health Laboratory Service, Tshwane Academic Division, Pretoria, South Africa;Department of Medical Microbiology, Faculty of Health Science, University of Pretoria, Private bag X323, arcadia, Pretoria, 0007, South Africa

关键词: XDR-TB;    TB;    MDR-TB;    BACTEC MGIT 960;   

Others  :  1158661
DOI  :  10.1186/1471-2334-12-369

 received in 2012-05-28, accepted in 2012-12-17,  发布年份 2012

【 摘 要 】

Background

The increasing problem of multi-drug-resistant (MDR) tuberculosis (TB) [ie resistant to at least isoniazid (INH) and rifampicin (RIF)] is becoming a global problem. Successful treatment outcome for MDR-TB depends on reliable and accurate drug susceptibility testing of first-line and second-line anti-TB drugs.

Method

Consecutive M. tuberculosis isolates identified as MDR-TB during August 2007 to January 2008 using the BACTEC MGIT 960 systems and the agar proportion method were included in this study. Susceptibility testing of MDR-TB isolates against ethambutol (EMB) and streptomycin (STR) as well as two second-line anti-TB drugs, kanamycin (KAN) and ofloxacin (OFX) was performed using the BACTEC MGIT 960 systems at a routine diagnostic laboratory. The results were compared to those obtained by the agar proportion method.

Result

The agreement between the BACTEC MGIT 960 system and the agar proportion method was 44% for EMB, 61% for STR and 89% for both KAN and OFX. The sensitivity and specificity of the BACTEC MGIT 960 system using the agar proportion method as a gold standard was 92% and 37% for EMB, 95% and 37% for STR, 27% and 97% for KAN and 84% and 90% for OFX, respectively.

Conclusions

The BACTEC MGIT 960 system showed acceptable sensitivity for EMB, STR, and OFX; however, the BACTEC MGIT 960 system was less specific for EMB and STR and demonstrated a low sensitivity for KAN. The lower agreement found between the two methods suggests the unreliability of the BACTEC MGIT 960 system for the drugs tested. The reasons for the lower agreement between the two methods need to be investigated and further studies are needed in this setting to confirm the study finding.

【 授权许可】

   
2012 Said et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]World Health Organization: Multidrug and extensively drug-resistant TB (M/XDR-TB) 2010 Global report on surveillance and response. Geneva, Switzerland: World Health Organization; 2010.
• [2]Centers for Disease Control and Prevention: Notice to readers: Revised definition of extensively drug-resistant tuberculosis. MMWR 2006, 55:1176.
• [3]Palomino JC, Martin A, Von Groll A, Portaels F: Rapid culture-based methods for drug-resistance detection in Mycobacterium tuberculosis. J Microbiol Methods 2008, 75:161-166.
• [4]Richter E, Rüsch-Gerdes S, Hillemann D: Drug-susceptibility testing in TB: current status and future prospects. Expert Rev Respir Med 2009, 3:497-510.
• [5]O’Grady J, Maeurer M, Mwaba P, Kapata N, Bates M, Hoelscher M, Zumla A: New and improved diagnostics for detection of drug resistant pulmonary tuberculosis. Curr Opin Pulm Med 2011, 17:134-141.
• [6]Parsons LM, Somoskövi A, Urbanczik R, Salfinger M: Laboratory diagnostic aspects of drug resistant tuberculosis. Front Biosci 2004, 9:2086-2105.
• [7]Johnson R, Jordaan AM, Pretorius L, Engelke E, van der Spuy G, Kewley C, Bosman M, Van Helden PD, Warren R, Victor TC: Ethambutol resistance testing by mutation detection. Int J Tuberc Lung Dis 2006, 10:68-73.
• [8]Canetti G, Froman F, Grosset J, Hauduroy P, Langerova M, Mahler HT, Meissner G, Mitchison DA, Sula L: Mycobacteria: laboratory methods for testing drug sensitivity and resistance. Bull WHO 1963, 29:565-578.
• [9]Heifets LB: Drug susceptibility in chemotherapy of mycobacterial infections. 1st edition. Florida: CRC press; 2000.
• [10]Tenover FC, Crawford JT, Huebner RE, Geiter LJ, Horsburgh CR Jr, Good RC: The resurgence of tuberculosis: is your laboratory ready? J Clin Microbiol 1993, 31:767-770.
• [11]Parrish N, Carrol K: Importance of improved TB diagnostics in addressing the extensively drug-resistant TB crisis. Future Microbiol 2008, 3:405-413.
• [12]World Health Organization: Strategic and technical advisory group for tuberculosis (STAG-TB). Report on conclusions and recommendations11 to 13 June 2007. Geneva, Switzerland: World Health Organization; 2007.
• [13]BD: BACTEC™ MGIT™ 960 SIRE kit for the antimycobacterial susceptibility testing of Mycobacterium tuberculosis. Franklin Lakes, NJ, USA: Becton Dickinson and Company; 2002.
• [14]Rüsch-Gerdes S, Domehl C, Nardi G, Gismondo MR, Welscher HM, Pfyffer GE: Multicenter evaluation of the mycobacteria growth indicator tube for testing susceptibility of Mycobacterium tuberculosis to first-line drugs. J Clin Microbiol 1999, 37:45-48.
• [15]Ardito F, Posteraro B, Sanguinetti M, Zanetti S, Fadda G: Evaluation of BACTEC Mycobacteria Growth Indicator Tube (MGIT 960) automated system for drug susceptibility testing of Mycobacterium tuberculosis. J Clin Microbiol 2001, 39:4440-4444.
• [16]Bemer P, Palicova F, Rusch-Gerdes S, Drugeon HB, Pfyffer GE: Multicenter evaluation of fully automated BACTEC Mycobacteria Growth Indicator Tube 960 system for susceptibility testing of Mycobacterium tuberculosis. J Clin Microbiol 2002, 40:150-154.
• [17]Tortoli E, Benedetti M, Fontanelli A, Simonetti MT: Evaluation of automated BACTEC MGIT 960 system for testing susceptibility of Mycobacterium tuberculosis to four major anti-tuberculous drugs: comparison with the radiometric BACTEC 460TB method and the agar plate method of proportion. J Clin Microbiol 2002, 40:607-610.
• [18]Krüüner A, Yates MD, Drobniewski FA: Evaluation of MGIT 960-based antimicrobial testing and determination of critical concentrations of first- and second-line antimicrobial drugs with drug-resistant clinical strains of Mycobacterium tuberculosis. J Clin Microbiol 2006, 44:811-818.
• [19]Rüsch-Gerdes S, Pfyffer GE, Casal M, Chadwick M, Siddiqi S: Multicenter laboratory validation of the BACTEC MGIT 960 technique for testing susceptibilities of Mycobacterium tuberculosis to classical second-line drugs and newer antimicrobials. J Clin Microbiol 2006, 44:688-692.
• [20]Rodrigues C, Jani J, Shenai S, Thakkar P, Siddiqi S, Mehta A: Drug susceptibility testing of Mycobacterium tuberculosis against second-line drugs using the BACTEC MGIT 960 System. Int J Tuberc Lung Dis 2008, 12:1449-1455.
• [21]Lin SY, Desmond E, Bonato D, Gross W, Siddiqi S: Multicenter evaluation of BACTEC MGIT 960 system for second-line drug susceptibility testing of Mycobacterium tuberculosis complex. J Clin Microbiol 2009, 47:3630-3634.
• [22]World Health Organization: Policy guidance on drug susceptibility testing (DST) of second-line anti-tuberculosis drugs. Geneva, Switzerland: World Health Organization; 2008. [WHO/HTM/TB/2008.392]
• [23]World Health Organization: Guidelines for drug susceptibility testing for second line anti-tuberculosis drugs for DOTS-Plus. Geneva, Switzerland: World Health Organization; 2001. [Document no. WHO/CDS/TB/2001.288]
• [24]World Health Organization: The WHO/IUATLD global project on anti-tuberculosis drug resistance surveillance. Geneva, Switzerland: World Health Organization; 2000. [Anti-tuberculosis drug resistance in the world, report no. 2: prevalence and trends]
• [25]Laszlo A, Rahman M, Raviglione M, Bustreo F: Quality assurance programme for drug susceptibility testing of Mycobacterium tuberculosis in the WHO/IUATLD Supranational Laboratory Network: first round of proficiency testing. Int J Tuberc Lung Dis 1997, 1:231-238.
• [26]Laszlo A, Rahman M, Espinal M, Raviglione M: WHO/IUATLD Network of Supranational Reference Laboratories: Quality assurance programme for drug susceptibility testing of Mycobacterium tuberculosis in the WHO/IUATLD Supranational Reference Laboratory Network: five rounds of proficiency testing, 1994–1998. Int J Tuberc Lung Dis 2002, 6:748-756.
• [27]Woodley CL: Evaluation of streptomycin and ethambutol concentrations for susceptibility testing of Mycobacterium tuberculosis by radiometric and conventional procedures. J Clin Microbiol 1986, 23:385-386.
• [28]Van Rie A, Warren R, Mshanga I, Jordaan AM, Van der Spuy GD, Richardson M, Simpson J, Gie RP, Enarson DA, Beyers N, Van Helden PD, Victor TC: Analysis for a limited number of gene codons can predict drug-resistance of Mycobacterium tuberculosis in a high-incidence community. J Clin Microbiol 2001, 39:636-641.
• [29]Mokrousov I, Narvskaya O, Limeschenko E, Otten T, Vyshnevskiy B: Detection of ethambutol-resistant Mycobacterium tuberculosis strains by multiplex allele-specific PCR assay targeting embB306 mutations. J Clin Microbiol 2002, 40:1617-1620.
• [30]Devasia RA, Blackman A, May C, Eden S, Smith T, Hooper N, Maruri F, Stratton S, Shintani A, Sterling TR: Fluoroquinolone resistance inMycobacterium tuberculosis: an assessment of MGIT 960, MODS and nitrate reductase assay and fluoroquinolone cross-resistance. J Antimicrob Chemother 2009, 63:1173-1178.
• [31]Martin A, Von Groll A, Fissette K, Palomino JC, Varaine F, Portaels F: Rapid detection of Mycobacterium tuberculosis resistance to second-line drugs by use of the manual Mycobacterium growth indicator tube system. J Clin Microbiol 2008, 46:3952-3956.
• [32]Bastian I, Rigouts L, Palomino JC, Portaels F: Kanamycin Susceptibility Testing of Mycobacterium tuberculosis using Mycobacterium Growth Indicator Tube and a Colorimetric method. Antimicrob Agents Chemother 2001, 45:1934-1936.
• [33]Juréen P, Ängeby K, Sturegård E, Chryssanthou E, Giske CG, Werngren J, Nordvall M, Johansson A, Kahlmeter G, Hoffner S, Schön T: Wild-Type MIC distributions for aminoglycoside and cyclic polypeptide antibiotics used for treatment of Mycobacterium tuberculosis Infections. J Clin Microbiol 2010, 48:1853-1858.
• [34]Ängeby K, Giske CG, Juréen P, Schön T: Wild-Type MIC distributions must be considered to set clinically meaningful susceptibility testing breakpoints for all bacterial pathogens, including Mycobacterium tuberculosis. Antimicrob Agents Chemother 2011, 55:4492-4493.
• [35]Morcillo N, Imperiale B, Di Giulio B: Evaluation of MGIT 960 and the colorimetric-based method for tuberculosis drug susceptibility testing. Int J Tuberc Lung Dis 2010, 14:1169-1175.
• [36]World Health Organization: Framework for implementing new tuberculosis diagnostics. Geneva, Switzerland: World Health Organization; 2010.
• [37]World Health Organization: Molecular line probe assays for rapid screening of patients at risk of multidrug resistant tuberculosis. Geneva, Switzerland: World Health Organization; 2008.
• [38]National Committee for Clinical Laboratory Standards: Susceptibility testing for Mycobacteria, Nocardiae, and other aerobic Actinomycetes; approved standard. Volume 23: (18), NCCLS document, pM-24A. NCCLS: Wayne, PA; 2003.
• [39]Landis JR, Koch GG: The measurement of observer agreement for categorical data. In Biometrics 1977, Volume 33:159-174.