Diagnostic accuracy and usefulness of the Genotype MTBDRplus assay in diagnosing multidrug-resistant tuberculosis in Cameroon: a cross-sectional study

BMC Infectious Diseases

Research Article

Ngu Njei Abanda¹  Diane Wallace Taylor²  Veronique Mbeng Penlap³  Rose Gana Fomban Leke⁴  Sara Irene Eyangoh⁵  Josiane Yvonne Djieugoué⁵  Eunjung Lim⁶  Eric Walter Pefura-Yone⁷  Wilfred Fon Mbacham⁸  Guy Vernet⁹ 

[1] Biotechnology Centre, University of Yaounde I, PO Box: 3851, Yaounde, Cameroon;Department of Tropical Medicine, Medical Microbiology and Pharmacology, University of Hawaii, 96813, Honolulu, HI, USA;Department of Tropical Medicine, Medical Microbiology and Pharmacology, University of Hawaii, 96813, Honolulu, HI, USA;Laboratory for Tuberculosis Research (LTR), Biotechnology Centre (BTC)-Nkolbison, University of Yaoundé I, Yaoundé, Cameroon;Laboratory of Immunology and Parasitology, the Biotechnology Centre, University of Yaoundé 1, Yaoundé, Cameroon;Mycobacteriology Service, Centre Pasteur of Cameroon, PO Box: 1274, Yaounde, Cameroon;Office of Biostatistics and Quantitative Health Sciences, University of Hawaii, 96813, Honolulu, HI, USA;Pneumology service, Yaounde Jamot Hospital, P.O Box: 4021, Yaounde, Cameroon;The Biotechnology Centre, University of Yaoundé 1, 8094, Yaoundé, BP, Cameroon;Virology Service, Centre Pasteur of Cameroon, P.O. Box 1274, Yaoundé, Cameroon;

关键词: Multidrug-resistant tuberculosis (MDR-TB);    Genotype MTBDRplus assay;    Pulmonary tuberculosis;    InhA;    KatG;    rpoB;   

DOI  :  10.1186/s12879-017-2489-3

 received in 2016-10-17, accepted in 2017-05-23,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundDrug-resistant tuberculosis, especially multidrug-resistant tuberculosis (MDR-TB), is a major public health problem. Effective management of MDR-TB relies on accurate and rapid diagnosis. In this study, we assessed the diagnostic accuracy of the Genotype MTBDRplus assay in diagnosing MDR-TB in Cameroon, and then discuss on its utility within the diagnostic algorithm for MDR-TB.MethodsIn this cross-sectional study, 225 isolates of Mycobacterium tuberculosis cultured from sputum samples collected from new and previously treated pulmonary tuberculosis patients in Cameroon were used to determine the accuracy of the Genotype MTBDRplus assay. We compared the results of the Genotype MTBDRplus assay with those from the automated liquid culture BACTEC MGIT 960 SIRE system for sensitivity, specificity, and degree of agreement. The pattern of mutations associated with resistance to RIF and INH were also analyzed.ResultsThe Genotype MTBDRplus assay correctly identified Rifampicin (RIF) resistance in 48/49 isolates (sensitivity, 98% [CI, 89%–100%]), Isoniazid (INH) resistance in 55/60 isolates (sensitivity 92% [CI, 82%–96%]), and MDR-TB in 46/49 (sensitivity, 94% [CI, 83%–98%]). The specificity for the detection of RIF-resistant and MDR-TB cases was 100% (CI, 98%–100%), while that of INH resistance was 99% (CI, 97%–100%). The agreement between the two tests for the detection of MDR-TB was very good (Kappa = 0.96 [CI, 0.92–1.00]). Among the 3 missed MDR-TB cases, the Genotype MTBDRplus assay classified two samples as RIF-monoresistant and one as INH monoresistant.The most frequent mutations detected by the Genotype MTBDRplus assay was the rpoB S531 L MUT3 41/49 (84%) in RIF-resistant isolates, and the KatG S315 T1 (MUT1) 35/55 (64%) and inhA C15T (MUT1) 20/55 (36%) mutations in INH-resistant isolates.ConclusionThe Genotype MTBDRplus assay had good accuracy and could be used for the diagnosis of MDR-TB in Cameroon. For routine MDR-TB diagnosis, this assay could be used for Mycobacterium tuberculosis cultures containing contaminants, to complement culture-based drug susceptibility testing or to determine drug resistant mutations.

【 授权许可】

CC BY   
© The Author(s). 2017