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CC BY-NC-ND 4.0 · J Lab Physicians 2017; 9(02): 089-094
DOI: 10.4103/0974-2727.199626
Original Article

Concurrent evaluation of microscopic observation of drug susceptibility assay for pulmonary and extrapulmonary tuberculosis

Sonali Sudhir Zadbuke
Department of Microbiology, Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India
,
Reena Set
Department of Microbiology, T. N. M. C. and B. Y. L. Nair Ch. Hospital, Mumbai, Maharashtra, India
,
Nishat Khan
Department of Microbiology, T. N. M. C. and B. Y. L. Nair Ch. Hospital, Mumbai, Maharashtra, India
,
Jayanthi Shastri
Department of Microbiology, T. N. M. C. and B. Y. L. Nair Ch. Hospital, Mumbai, Maharashtra, India
› Institutsangaben Financial support and sponsorship The financial support was provided by Research Society, Topiwala National Medical College, and BYL Nair Charitable Hospital.
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Abstract

BACKGROUND: Methods for detection and drug susceptibility of tuberculosis (TB) with solid media are inexpensive but slow and laborious. Rapid methods to diagnose TB and multidrug-resistant TB (MDR-TB) are a global priority for TB control.

OBJECTIVES: A study was performed to compare the sensitivity of detection of mycobacterial growth and time of culture positivity by microscopic observation of drug susceptibility (MODS) assay with that of Lowenstein–Jensen (LJ) culture in pulmonary and extrapulmonary TB and to evaluate the concordance of the susceptibilities to isoniazid (INH) and rifampicin (RIF) by MODS and proportion method on LJ.

MATERIALS AND METHODS: A prospective, laboratory-based study was conducted on a total of 300 samples from suspected cases of pulmonary and extrapulmonary TB. Samples were inoculated on LJ medium as per the standard guidelines and MODS assay was performed.

RESULTS: Sensitivity of MODS assay was 80% and 83.3% and specificity was 92.9% and 83.3% for pulmonary and extrapulmonary samples, respectively. Difference between mean time to detection of Mycobacterium TB (MTB) by LJ medium and MODS was statistically significant, with MODS being faster. drug susceptibility testing (DST) by MODS when compared to economic variant of proportion method was 87.87% for RIF, 90.9% for INH, and 96.96% for MDR-TB detection.

CONCLUSIONS: MODS assay provides rapid, safe, and sensitive detection of TB faster than the existing gold standard. It is extremely promising in effectively diagnosing MDR-TB.

Keywords

Extrapulmonary tuberculosis - microscopic observation of drug susceptibility assay - pulmonary tuberculosis


Publikationsverlauf

Eingereicht: 15. Februar 2016

Angenommen: 05. August 2016

Artikel online veröffentlicht:
19. Februar 2020

© 2017.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Narain JP. Tuberculosis: epidemiology and control. Tuberculosis: epidemiology and control. 2002.
  • 2 WHO. Global Tuberculosis Report 2014. Geneva: WHO; 2014. p. 1-289.
  • 3 TB Diagnostics and Laboratory Services. Available from: http://www.who.int/tb/dots/lab.pdf. [Last accessed on 2016 Feb 05].
  • 4 Moore DA, Mendoza D, Gilman RH, Evans CA, Hollm Delgado MG, Guerra J, et al. Microscopic observation drug susceptibility assay, a rapid, reliable diagnostic test for multidrug-resistant tuberculosis suitable for use in resource-poor settings. J Clin Microbiol 2004;42:4432-7.
  • 5 Coronel J, Roper M, Caviedes L, Moore DA. MODS: A user guide. Lima Peru : Universidad Peruana Cayetano Heredia, 2008.
  • 6 Singh S, Kumar P, Sharma S, Mumbowa F, Martin A, Durier N. Rapid identification and drug susceptibility testing of Mycobacterium tuberculosis: Standard operating procedure for non-commercial assays: Part 1: Microscopic observation drug susceptibility assay v2.4.12. J Lab Physicians 2012;4:101-11.
  • 7 World Health Organization. Laboratory services in tuberculosis control. Part III. Culture. Geneva, Switzerland: WHO; 1998.
  • 8 Moore DA, Evans CA, Gilman RH, Caviedes L, Coronel J, Vivar A, et al. Microscopic-observation drug-susceptibility assay for the diagnosis of TB. N Engl J Med 2006;355:1539-50.
  • 9 Michael JS, Daley P, Kalaiselvan S, Latha A, Vijayakumar J, Mathai D, et al. Diagnostic accuracy of the microscopic observation drug susceptibility assay: A pilot study from India. Int J Tuberc Lung Dis 2010;14:482-8.
  • 10 Shah NS, Moodley P, Babaria P, Moodley S, Ramtahal M, Richardson J, et al. Rapid diagnosis of tuberculosis and multidrug resistance by the microscopic-observation drug-susceptibility assay. Am J Respir Crit Care Med 2011;183:1427-33.
  • 11 Mashta A, Mishra P, Philipose S, Tamilzhalagan S, Mahmud H, Bhaskar S, et al. Diagnosis of tuberculosis: The experience at a specialized diagnostic laboratory. J Negat Results Biomed 2011;10:16.
  • 12 Attorri S, Dunbar S, Clarridge JE 3rd. Assessment of morphology for rapid presumptive identification of Mycobacterium tuberculosis and Mycobacterium kansasii. J Clin Microbiol 2000;38:1426-9.
  • 13 Tovar M, Siedner MJ, Gilman RH, Santillan C, Caviedes L, Valencia T, et al. Improved diagnosis of pleural tuberculosis using the microscopic- observation drug-susceptibility technique. Clin Infect Dis 2008;46:909-12.
  • 14 Caws M, Dang TM, Torok E, Campbell J, Do DA, Tran TH, et al. Evaluation of the MODS culture technique for the diagnosis of tuberculous meningitis. PLoS One 2007;2:e1173.
  • 15 Thwaites GE, Chau TT, Farrar JJ. Improving the bacteriological diagnosis of tuberculous meningitis. J Clin Microbiol 2004;42:378-9.
  • 16 Kennedy DH, Fallon RJ. Tuberculous meningitis. JAMA 1979;241:264-8.
  • 17 Ha DT, Lan NT, Wolbers M, Duong TN, Quang ND, Thi Van Thinh T, et al. Microscopic observation drug susceptibility assay (MODS) for early diagnosis of tuberculosis in children. PLoS One 2009;4:e8341.
  • 18 Limaye K, Kanade S, Nataraj G, Mehta P. Utility of microscopic observation of drug susceptibility (MODS) assay for Mycobacterium tuberculosis in resource constrained settings. Indian J Tuberc 2010;57:207-12.
  • 19 Arias M, Mello FC, Pavón A, Marsico AG, Alvarado-Gálvez C, Rosales S, et al. Clinical evaluation of the microscopic-observation drug-susceptibility assay for detection of tuberculosis. Clin Infect Dis 2007;44:674-80.
  • 20 Lazarus RP, Kalaiselvan S, John KR, Michael JS. Evaluation of the microscopic observational drug susceptibility assay for rapid and efficient diagnosis of multi-drug resistant tuberculosis. Indian J Med Microbiol 2012;30:64-8.
  • 21 Shiferaw G, Woldeamanuel Y, Gebeyehu M, Girmachew F, Demessie D, Lemma E. Evaluation of microscopic observation drug susceptibility assay for detection of multidrug-resistant Mycobacterium tuberculosis. J Clin Microbiol 2007;45:1093-7.