An integrated approach to rapid diagnosis of tuberculosis and multidrug resistance using liquid culture and molecular methods in Russia.

<h4>Objective</h4>To analyse the feasibility, cost and performance of rapid tuberculosis (TB) molecular and culture systems, in a high multidrug-resistant TB (MDR TB) middle-income region (Samara, Russia) and provide evidence for WHO policy change.<h4>Methods</h4>Performance...

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Autores principales: Yanina Balabanova, Francis Drobniewski, Vladyslav Nikolayevskyy, Annika Kruuner, Nadezhda Malomanova, Tatyana Simak, Nailya Ilyina, Svetlana Zakharova, Natalya Lebedeva, Heather L Alexander, Rick O'Brien, Hojoon Sohn, Anastasia Shakhmistova, Ivan Fedorin
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Publicado: Public Library of Science (PLoS) 2009
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spelling oai:doaj.org-article:96a78f8c3f25405b868d9755bf8517d42021-12-02T20:12:05ZAn integrated approach to rapid diagnosis of tuberculosis and multidrug resistance using liquid culture and molecular methods in Russia.1932-620310.1371/journal.pone.0007129https://doaj.org/article/96a78f8c3f25405b868d9755bf8517d42009-09-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19774085/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>To analyse the feasibility, cost and performance of rapid tuberculosis (TB) molecular and culture systems, in a high multidrug-resistant TB (MDR TB) middle-income region (Samara, Russia) and provide evidence for WHO policy change.<h4>Methods</h4>Performance and cost evaluation was conducted to compare the BACTEC MGIT 960 system for culture and drug susceptibility testing (DST) and molecular systems for TB diagnosis, resistance to isoniazid and rifampin, and MDR TB identification compared to conventional Lowenstein-Jensen culture assays.<h4>Findings</h4>698 consecutive patients (2487 sputum samples) with risk factors for drug-resistant tuberculosis were recruited. Overall M. tuberculosis complex culture positivity rates were 31.6% (787/2487) in MGIT and 27.1% (675/2487) in LJ (90.5% and 83.2% for smear-positive specimens). In total, 809 cultures of M. tuberculosis complex were isolated by any method. Median time to detection was 14 days for MGIT and 36 days for LJ (10 and 33 days for smear positive specimens) and indirect DST in MGIT took 9 days compared to 21 days on LJ. There was good concordance between DST on LJ and MGIT (96.8% for rifampin and 95.6% for isoniazid). Both molecular hybridization assay results correlated well with MGIT DST results, although molecular assays generally yielded higher rates of resistance (by approximately 3% for both isoniazid and rifampin).<h4>Conclusion</h4>With effective planning and logistics, the MGIT 960 and molecular based methodologies can be successfully introduced into a reference laboratory setting in a middle incidence country. High rates of MDR TB in the Russian Federation make the introduction of such assays particularly useful.Yanina BalabanovaFrancis DrobniewskiVladyslav NikolayevskyyAnnika KruunerNadezhda MalomanovaTatyana SimakNailya IlyinaSvetlana ZakharovaNatalya LebedevaHeather L AlexanderRick O'BrienHojoon SohnAnastasia ShakhmistovaIvan FedorinPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 4, Iss 9, p e7129 (2009)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Yanina Balabanova
Francis Drobniewski
Vladyslav Nikolayevskyy
Annika Kruuner
Nadezhda Malomanova
Tatyana Simak
Nailya Ilyina
Svetlana Zakharova
Natalya Lebedeva
Heather L Alexander
Rick O'Brien
Hojoon Sohn
Anastasia Shakhmistova
Ivan Fedorin
An integrated approach to rapid diagnosis of tuberculosis and multidrug resistance using liquid culture and molecular methods in Russia.
description <h4>Objective</h4>To analyse the feasibility, cost and performance of rapid tuberculosis (TB) molecular and culture systems, in a high multidrug-resistant TB (MDR TB) middle-income region (Samara, Russia) and provide evidence for WHO policy change.<h4>Methods</h4>Performance and cost evaluation was conducted to compare the BACTEC MGIT 960 system for culture and drug susceptibility testing (DST) and molecular systems for TB diagnosis, resistance to isoniazid and rifampin, and MDR TB identification compared to conventional Lowenstein-Jensen culture assays.<h4>Findings</h4>698 consecutive patients (2487 sputum samples) with risk factors for drug-resistant tuberculosis were recruited. Overall M. tuberculosis complex culture positivity rates were 31.6% (787/2487) in MGIT and 27.1% (675/2487) in LJ (90.5% and 83.2% for smear-positive specimens). In total, 809 cultures of M. tuberculosis complex were isolated by any method. Median time to detection was 14 days for MGIT and 36 days for LJ (10 and 33 days for smear positive specimens) and indirect DST in MGIT took 9 days compared to 21 days on LJ. There was good concordance between DST on LJ and MGIT (96.8% for rifampin and 95.6% for isoniazid). Both molecular hybridization assay results correlated well with MGIT DST results, although molecular assays generally yielded higher rates of resistance (by approximately 3% for both isoniazid and rifampin).<h4>Conclusion</h4>With effective planning and logistics, the MGIT 960 and molecular based methodologies can be successfully introduced into a reference laboratory setting in a middle incidence country. High rates of MDR TB in the Russian Federation make the introduction of such assays particularly useful.
format article
author Yanina Balabanova
Francis Drobniewski
Vladyslav Nikolayevskyy
Annika Kruuner
Nadezhda Malomanova
Tatyana Simak
Nailya Ilyina
Svetlana Zakharova
Natalya Lebedeva
Heather L Alexander
Rick O'Brien
Hojoon Sohn
Anastasia Shakhmistova
Ivan Fedorin
author_facet Yanina Balabanova
Francis Drobniewski
Vladyslav Nikolayevskyy
Annika Kruuner
Nadezhda Malomanova
Tatyana Simak
Nailya Ilyina
Svetlana Zakharova
Natalya Lebedeva
Heather L Alexander
Rick O'Brien
Hojoon Sohn
Anastasia Shakhmistova
Ivan Fedorin
author_sort Yanina Balabanova
title An integrated approach to rapid diagnosis of tuberculosis and multidrug resistance using liquid culture and molecular methods in Russia.
title_short An integrated approach to rapid diagnosis of tuberculosis and multidrug resistance using liquid culture and molecular methods in Russia.
title_full An integrated approach to rapid diagnosis of tuberculosis and multidrug resistance using liquid culture and molecular methods in Russia.
title_fullStr An integrated approach to rapid diagnosis of tuberculosis and multidrug resistance using liquid culture and molecular methods in Russia.
title_full_unstemmed An integrated approach to rapid diagnosis of tuberculosis and multidrug resistance using liquid culture and molecular methods in Russia.
title_sort integrated approach to rapid diagnosis of tuberculosis and multidrug resistance using liquid culture and molecular methods in russia.
publisher Public Library of Science (PLoS)
publishDate 2009
url https://doaj.org/article/96a78f8c3f25405b868d9755bf8517d4
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