We encourage circulation of this report to personnel who are involved with drug susceptibility testing dst, reporting, or interpreting for m. Drugsusceptibility testing in tuberculosis european respiratory. Centers for disease control and prevention cdc model performance evaluation program mpep for mycobacterium tuberculosis complex mtbc drug susceptibility. Rapid diagnosis of mycobacterium tuberculosis infection and drug susceptibility testing michael l.
Reporting of erroneous dst results to the treating physician has adulterous effects on patients. The number of mtbc isolates tested for drug susceptibility by the 80 participants in 2016 excluding isolates used for quality control is shown in figure 2. Wilson 20 rapid diagnosis of mycobacterium tuberculosis infection and drug susceptibility testing. What methods are available for antimicrobial susceptibility testing ast for tb. The coming of age of drugsusceptibility testing for. The global control of tuberculosis remains a challenge from the standpoint of diagnosis, detection of drug resistance, and treatment. Outbreaks could be detected from the same data at no additional cost, potentially adding to local tuberculosis control. Antimicrobial susceptibility test interpretive category a classification based on an. Drug susceptibility of mycobacterium tuberculosis beijing. This multicenter study was carried out to evaluate if drug susceptibility testing dst can be successfully carried out directly from processed smearpositive specimens direct dst and if this approach could offer substantial time. The rising number of multidrugresistant mycobacterium tuberculosis strains substantiates the urgent demand for rapid and reliable techniques for the detection of drugresistant tb. Accurate drug susceptibility testing dst for mycobacterium tuberculosis is highly important. Who consolidated guidelines on drugresistant tuberculosis treatment 6 key definitions2 drugsusceptibility testing dst refers to invitro testing using either phenotypic methods to determine susceptibility or molecular techniques to detect resistanceconferring mutations to a.
Drug susceptibility testing of mycobacterium tuberculosis by the broth microdilution method with 7h9 broth. Annual number of mtbc drug susceptibility tests performed the number of mtbc isolates tested for drug susceptibility by the 72 participants in 2018 excluding isolates used for quality control is shown in figure 2. Susceptibility testing using the mgit 960 system with epicenter tb exist software. The many facets of drug susceptibility testing for.
Proper management of multidrugresistant tuberculosis mdrtb requires accurate drug susceptibility testing dst of mycobacterium tuberculosis isolates to other ethambutol emb, pyrazinamide, and streptomycin sm firstline drugs. Quantitative drug susceptibility testing of mycobacterium. Although liquid medium dst methods are used increasingly and seem most efficient and. Annual number of mycobacterium tuberculosis complex drug susceptibility tests performed. Internal quality control procedures for drug susceptibility testing of m. Wholegenome sequencing for prediction of mycobacterium. This is an area of special concern to the health of women and children, particularly. Form lab 444 0312 mdln25, examination for mycobacteria tuberculosis drug susceptibility. The proportion of tb cases with drug susceptibility testing results increased from 24. Centers for disease control and prevention cdc model performance evaluation program mpep for mycobacterium tuberculosis complex mtbc drug susceptibility testing survey sent to participants in march 2019. Morbidity and mortality are higher for drug resistant cases, particularly if they are multiple drug resistant tb mdrtb i. Rapid diagnosis of mycobacterium tuberculosis infection. Pdf simple procedure for drug susceptibility testing of. Nitrooxidoreductase rv2466cdependent fluorescent probe for mycobacterium tuberculosis diagnosis and drug susceptibility testing ran mu school of pharmaceutical sciences, tsinghua university, haidian district, beijing 84, p.
Conventional andradiometric drug susceptibility testing of mycobacterium tuberculosis complex adalbertlaszlo, petergill, verahandzel,marym. The aim of this study was to evaluate a simple method using a commercial colorimetric assay alamar blue oxidationreduction indicator. Cortney stafford, mph, mt ascp, health scientist, laboratory capacity team, nchhstp, dtbe, lb. Conventional andradiometric drug susceptibility testing of. Comparative evaluation of the nitrate reduction assay, the. Mutations in mycobacterium tuberculosis isolates with. This study compared the performance of mycobacterium growth indicator tube mgit 960 system for dst of mdrtb isolates with polymerase chain reaction pcr. Keywords drug resistance, eucast, mycobacterium tuberculosis. Helbecque nationalreference centrefor tuberculosis, laboraton centrefordisease control, tunnevs pasture, ottawa, ontario kiaol2 canada received 2 june 1983accepted 19 september 1983.
The sensititre broth microdilution assay bmd tests multiple drugs quantitatively. We assessed the trends of mdrtb among both new and recurrent tb cases. Internal quality control of the media is an essential part of. Although liquid medium dst methods are used increasingly and seem most efficient and fast, the high costs hamper widespread implementation. As a first study of its type, the inconsistencies in reporting dst results of rifampicin and isoniazid from saudi arabia were assessed. To assess the performance and feasibility of the introduction of the thinlayer agar mdrxdrtb colour test colour test. Learn about tb signs and symptoms and the laboratory tests used to screen for and diagnose tuberculosis as well as about multidrug resistant tuberculosis mdrtb and extensively resistant tuberculosis xdrtb. Although microtitre plates have the potential to enable highthroughput phenotypic testing of m. Automated detection of bacterial growth on 96well plates. Antimicrobial susceptibility testing of mycobacterium. Impact of universal drug susceptibility testing and. Tuberculosis tb is an infection caused by mycobacterium tuberculosis that primarily affects the lungs.
We computed the trends of both incidence and prevalence of mdrtb from 20072016. While future studies have to address the correlation of phenotypic resistance levels and treatment outcomes, a prerequisite for corresponding. Who technical manual for drug susceptibility testing of. Susceptibility of mycobacterium tuberculosis complex mtbc isolates to emb can be discerned by dna sequencing to detect mutations in the embb gene associated with resistance. Peru is one of the 30 countries in the world with the highest burden of multidrugresistant tuberculosis mdrtb. Ethambutol emb is used as a part of drug regimens for treatment of tuberculosis tb. Mycobacterium tuberculosis complex drug susceptibility test description drug susceptibility testing of mycobacterium tuberculosis complex isolates to the antituberculous drugs streptomycin, isoniazid, rifampin, ethambutol, and pyrazinamide. In england and wales, for example, most hospital laboratories submit isolates of m. The number of mtbc isolates tested for drug susceptibility by the 79 participants in 2015 excluding isolates used for quality control is shown in figure 2. Quality assurance for the world health organization whointernational union against tuberculosis and lung disease the union global tuberculosis tb drug resistance surveillance programme.
Drug susceptibility testing of mycobacterium tuberculosis complex. Since numbers of drugresistant mycobacterium tuberculosis strains are on the rise, the simple classification into susceptible and resistant strains based on susceptibility testing at critical concentrations has to be reconsidered. Use of drugsusceptibility testing for management of drug. In 2004, routine use of culture and drugsusceptibility testing dst was implemented for persons in 5 thailand provinces with a diagnosis of tuberculosis tb. Molecular screening versus phenotypic susceptibility. The first surprise is that ast for tb is called drug susceptibility testing dst. Rapid drug susceptibility testing of mycobacterium tuberculosis using conventional solid media article pdf available in european respiratory journal 810. With increasing incidence of multidrugresistant tuberculosis mdrtb, accurate drug susceptibility testing dst of mycobacterium tuberculosis to firstline drugs has become crucial for proper patient management. Conventional indirect drug susceptibility testing of mycobacterium tuberculosis with liquid medium is well established and offers timesaving and reliable results. Who consolidated guidelines on drugresistant tuberculosis. Mycobacterium tuberculosis drug susceptibility testing. Participants at 29 36% laboratories reported testing 50 or fewer dst isolates per year. Universal drug susceptibility testing dst is an important requirement of the end tb strategy.
Mycobacterium tuberculosis complex drug susceptibility. Tb drugsusceptibility testing expert panel meeting summary report december 12, 2007 atlanta, ga this report was produced in cooperation with the centers for disease control and prevention. Evaluation of the quantamatrix multiplexed assay platform system for simultaneous detection of mycobacterium tuberculosis and the rifampicin resistance gene. Diagnostic accuracy study of multiplex pcr for detecting tuberculosis drug resistance. In the diagnostic laboratory, drug susceptibility testing of mycobacterium tuberculosis is notably different from standard procedures in clinical microbiology, where a. Drug susceptibility testing of mycobacterium tuberculosis. The material in this report was developed and prepared by. To determine differences in the ability of mycobacterium tuberculosis strains to withstand antituberculosis drug treatment, we compared the activity of antituberculosis drugs against susceptible beijing and eastafricanindian genotype m. The resurgence of tuberculosis and outbreaks of multidrug resistant mdr tuberculosis have increased the emphasis for the development of new susceptibility testing of the mycobacterium tuberculosis for the effective treatment and control of the disease. Direct drug susceptibility testing of mycobacterium. Direct drug susceptibility testing of mycobacterium tuberculosis against primary antitb drugs in northern india. Accurate drug susceptibility testing dst for mycobacterium tuberculosis is highly important for both therapy guidance and surveillance of drug resistance.
Us public health laboratories phl primarily use growthbased drug susceptibility test dst methods to determine emb resistance. Molecular and growthbased drug susceptibility testing of mycobacterium tuberculosis complex for ethambutol resistance in the united states mitchella. Trial for drug susceptibility testing of mycobacterium. Pdf direct drug susceptibility testing of mycobacterium. Beijing genotype strains showed high rates of mutation within a wide range of drug concentrations, possibly explaining this genotype. Pdf the colour test for drug susceptibility testing of. Mycobacterium tuberculosis complex drug susceptibility testing report for march 2019 survey purpose the purpose of this report is to present results of the u. Nitrooxidoreductase rv2466cdependent fluorescent probe. Drug susceptibility testing report for march 2019 survey purpose the purpose of this report is to present results of the u. We also want to talk about drug susceptibility testing turnaround times and reporting, discuss discordance in dst results, discuss ensuring quality in dst, and give a. Yakrus,jeffreydriscoll,allisonmcalister,davidsikes, denisehartline,beverlymetchock,andangelam.
Editorial the new england journal of medicine 1474 n engl j med 379. The public health system provides free diagnosis and drugsusceptibility testing with phenotypic proportions in 7h10 and molecular methods. The bactec mgit 960 system is an accurate and reliable method for rapid drug susceptibility testing dst of mycobacterium tuberculosis against secondline drugs. The emergence of multidrugresistant mdr and extensively. To monitor the quality of drug susceptibility testing. Drug susceptibility testing dst of mycobacterium tuberculosis is a crucial procedure to determine the effective drug regimen for patients treatment. The effective management of tb and mdrtb relies upon rapid diagnosis and effective treatment of resistant infections. As for other microbes, there are phenotypic and genotypic molecular methods available for performing susceptibility testing on isolates of mycobacterium tuberculosis.
Discordance across phenotypic and molecular methods for. The demand for reliable drugsusceptibility testing dst increases with the expansion of antituberculosis drugresistance surveillance, and with the need for an appropriate treatment of multidrugresistant tuberculosis, whose incidence. In the present study, few of the strains were resistant to fluoroquinolones and further dst for this group is required. Epidemiological cutoffs for sensititre susceptibility. Pdf rapid drug susceptibility testing of mycobacterium. Participants at 27 38% laboratories reported testing. The mgit 960 system was used for primary isolation and standard susceptibility testing of firstline drugs as recommended by the manufacturer. Accumed, usa in a microtiter format for testing the susceptibility of 94 strains of mycobacterium tuberculosis to. Here we present a software package, the automated mycobacterial growth detection algorithm amygda, that measures how much m. Evaluation of automated bactec mgit 960 system for testing susceptibility of mycobacterium tuberculosis to four major antituberculous drugs. The demand for reliable drugsusceptibility testing dst increases with the expansion of. Culturebased phenotypic drug susceptibility testing dst methods are currently the gold standard for drug resistance detection. Molecular and growthbased drug susceptibility testing of.