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Mambuque E, Saavedra B, Molina-Moya B, Nguenha D, García-García E, Blanco S, Gomes N, Ehrlich J, Bulo H, Munguambe S, Chiconela H, Acacio S, Domínguez J, García-Basteiro AL. Evaluation of Omnigene-Sputum for Preservation of Sputum Samples for Diagnosis of Mycobacterium tuberculosis. Trop Med Infect Dis 2023; 8:367. [PMID: 37505663 PMCID: PMC10386065 DOI: 10.3390/tropicalmed8070367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023] Open
Abstract
In several low-income countries, the transport of sputa could take up to one week to reach the laboratories, resulting in increased contamination rates and a loss of growth. The aim of this study was to evaluate the effect of the OMNIgene-SPUTUM in preserving Mycobacterium tuberculosis on sputum samples simulating three hypothetical scenarios for conservation and/or decontamination: (1) sputum was mixed with OMN and conserved at room temperature for five days and then processed for culture (OMN); (2) sputum cultures followed the routine standing operating procedure at day 0 (STD); and (3) sputum samples were kept at room temperature for five days and mixed with the standard decontamination reagent (SDT5) and then processed for culture. The positivity rate based on smear microscopy was 36.4%, 29.1%, and 27.3% for STD, STD5, and OMN, respectively. The proportion of positive results by liquid culture (MGIT) was 39.1% (43/110) for STD, 26.4% (29/110) for STD5, and 20.0% for OMN (22/110). The overall concordance of liquid culture results was 51.8% (57/110): 37.3% (41/110) for negative results, 11.8% (13/110) for MTBC growth, and 2.7% (3/110) for contaminated results. The OMN arm showed better performance in solid culture than in liquid culture, with a notable reduction in contaminated results.
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Affiliation(s)
- Edson Mambuque
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
| | - Belén Saavedra
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
- ISGlobal, Hospital Clínic, Universitat de Barcelona, 08026 Barcelona, Spain
| | - Barbara Molina-Moya
- Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 08916 Badalona, Spain
| | - Dinis Nguenha
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
| | - Esther García-García
- Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 08916 Badalona, Spain
| | - Silvia Blanco
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
| | - Neide Gomes
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
| | - Joanna Ehrlich
- ISGlobal, Hospital Clínic, Universitat de Barcelona, 08026 Barcelona, Spain
| | - Helder Bulo
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
| | - Shilzia Munguambe
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
| | - Helio Chiconela
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
- National Tuberculosis Control Program (PNCT), Maputo 1929, Mozambique
| | - Sozinho Acacio
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
| | - José Domínguez
- Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), 08916 Badalona, Spain
| | - Alberto L García-Basteiro
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
- ISGlobal, Hospital Clínic, Universitat de Barcelona, 08026 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), 08026 Barcelona, Spain
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2
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Domínguez J, Boeree MJ, Cambau E, Chesov D, Conradie F, Cox V, Dheda K, Dudnyk A, Farhat MR, Gagneux S, Grobusch MP, Gröschel MI, Guglielmetti L, Kontsevaya I, Lange B, van Leth F, Lienhardt C, Mandalakas AM, Maurer FP, Merker M, Miotto P, Molina-Moya B, Morel F, Niemann S, Veziris N, Whitelaw A, Horsburgh CR, Lange C. Clinical implications of molecular drug resistance testing for Mycobacterium tuberculosis: a 2023 TBnet/RESIST-TB consensus statement. Lancet Infect Dis 2023; 23:e122-e137. [PMID: 36868253 DOI: 10.1016/s1473-3099(22)00875-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 03/05/2023]
Abstract
Drug-resistant tuberculosis is a substantial health-care concern worldwide. Despite culture-based methods being considered the gold standard for drug susceptibility testing, molecular methods provide rapid information about the Mycobacterium tuberculosis mutations associated with resistance to anti-tuberculosis drugs. This consensus document was developed on the basis of a comprehensive literature search, by the TBnet and RESIST-TB networks, about reporting standards for the clinical use of molecular drug susceptibility testing. Review and the search for evidence included hand-searching journals and searching electronic databases. The panel identified studies that linked mutations in genomic regions of M tuberculosis with treatment outcome data. Implementation of molecular testing for the prediction of drug resistance in M tuberculosis is key. Detection of mutations in clinical isolates has implications for the clinical management of patients with multidrug-resistant or rifampicin-resistant tuberculosis, especially in situations when phenotypic drug susceptibility testing is not available. A multidisciplinary team including clinicians, microbiologists, and laboratory scientists reached a consensus on key questions relevant to molecular prediction of drug susceptibility or resistance to M tuberculosis, and their implications for clinical practice. This consensus document should help clinicians in the management of patients with tuberculosis, providing guidance for the design of treatment regimens and optimising outcomes.
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Affiliation(s)
- José Domínguez
- Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, INNOVA4TB Consortium, Barcelona, Spain.
| | - Martin J Boeree
- Department of Lung Diseases, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Emmanuelle Cambau
- Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France, APHP-Hôpital Bichat, Mycobacteriology Laboratory, INSERM, University Paris Cite, IAME UMR1137, Paris, France
| | - Dumitru Chesov
- Department of Pneumology and Allergology, Nicolae Testemițanu State University of Medicine and Pharmacy, Chisinau, Moldova; Division of Clinical Infectious Diseases, Research Center Borstel, Leibniz Lung Center, Borstel, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg- Lübeck-Borstel-Riems, Borstel, Germany; Respiratory Medicine & International Health, University of Lübeck, Lübeck, Germany
| | - Francesca Conradie
- Department of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Vivian Cox
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Keertan Dheda
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine and UCT Lung Institute & South African MRC/UCT Centre for the Study of Antimicrobial Resistance, University of Cape Town, Cape Town, South Africa; Faculty of Infectious and Tropical Diseases, Department of Immunology and Infection, London School of Hygiene & Tropical Medicine, London, UK
| | - Andrii Dudnyk
- Department of Tuberculosis, Clinical Immunology and Allergy, National Pirogov Memorial Medical University, Vinnytsia, Ukraine; Public Health Center, Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Maha R Farhat
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA; Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Sebastien Gagneux
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Martin P Grobusch
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam Infection & Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Matthias I Gröschel
- Department of Infectious Diseases and Respiratory Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Lorenzo Guglielmetti
- Sorbonne Université, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, (Cimi-Paris), APHP Sorbonne Université, Department of Bacteriology Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France
| | - Irina Kontsevaya
- Division of Clinical Infectious Diseases, Research Center Borstel, Leibniz Lung Center, Borstel, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg- Lübeck-Borstel-Riems, Borstel, Germany; Respiratory Medicine & International Health, University of Lübeck, Lübeck, Germany; Department of Infectious Disease, Faculty of Medicine, Imperial College London, London, UK
| | - Berit Lange
- Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany; German Centre for Infection Research, TI BBD, Braunschweig, Germany
| | - Frank van Leth
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands; Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Christian Lienhardt
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; UMI 233 IRD-U1175 INSERM - Université de Montpellier, Institut de Recherche pour le Développement, Montpellier, France
| | - Anna M Mandalakas
- Division of Clinical Infectious Diseases, Research Center Borstel, Leibniz Lung Center, Borstel, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg- Lübeck-Borstel-Riems, Borstel, Germany; Respiratory Medicine & International Health, University of Lübeck, Lübeck, Germany; Global TB Program, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Florian P Maurer
- National and Supranational Reference Center for Mycobacteria, Research Center Borstel, Leibniz Lung Center, Borstel, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg- Lübeck-Borstel-Riems, Borstel, Germany; Institute of Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias Merker
- Division of Evolution of the Resistome, Research Center Borstel, Leibniz Lung Center, Borstel, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg- Lübeck-Borstel-Riems, Borstel, Germany
| | - Paolo Miotto
- Emerging Bacterial Pathogens Unit, Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Barbara Molina-Moya
- Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias, INNOVA4TB Consortium, Barcelona, Spain
| | - Florence Morel
- Sorbonne Université, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, (Cimi-Paris), APHP Sorbonne Université, Department of Bacteriology Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France
| | - Stefan Niemann
- Division of Molecular and Experimental Mycobacteriology, Research Center Borstel, Leibniz Lung Center, Borstel, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg- Lübeck-Borstel-Riems, Borstel, Germany; Department of Human, Biological and Translational Medical Sciences, School of Medicine, University of Namibia, Windhoek, Namibia
| | - Nicolas Veziris
- Sorbonne Université, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, (Cimi-Paris), APHP Sorbonne Université, Department of Bacteriology Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France
| | - Andrew Whitelaw
- Division of Medical Microbiology, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa; National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
| | - Charles R Horsburgh
- Departments of Epidemiology, Biostatistics, Global Health and Medicine, Boston University Schools of Public Health and Medicine, Boston, MA, USA
| | - Christoph Lange
- Division of Clinical Infectious Diseases, Research Center Borstel, Leibniz Lung Center, Borstel, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg- Lübeck-Borstel-Riems, Borstel, Germany; Respiratory Medicine & International Health, University of Lübeck, Lübeck, Germany; Global TB Program, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
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3
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Merker M, Nikolaevskaya E, Kohl TA, Molina-Moya B, Pavlovska O, Brännberg P, Dudnyk A, Stokich V, Barilar I, Marynova I, Filipova T, Prat C, Sjöstedt A, Dominguez J, Rzhepishevska O, Niemann S. Multidrug- and Extensively Drug-Resistant Mycobacterium tuberculosis Beijing Clades, Ukraine, 2015. Emerg Infect Dis 2021; 26:481-490. [PMID: 32091369 PMCID: PMC7045844 DOI: 10.3201/eid2603.190525] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) is an emerging threat to TB control in Ukraine, a country with the third highest XDR TB burden globally. We used whole-genome sequencing of a convenience sample to identify bacterial genetic and patient-related factors associated with MDR/XDR TB in this country. MDR/XDR TB was associated with 3 distinct Mycobacterium tuberculosis complex lineage 2 (Beijing) clades, Europe/Russia W148 outbreak, Central Asia outbreak, and Ukraine outbreak, which comprised 68.9% of all MDR/XDR TB strains from southern Ukraine. MDR/XDR TB was also associated with previous treatment for TB and urban residence. The circulation of Beijing outbreak strains harboring broad drug resistance, coupled with constraints in drug supply and limited availability of phenotypic drug susceptibility testing, needs to be considered when new TB management strategies are implemented in Ukraine.
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4
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Molina-Moya B, Guglielmetti L, Bothamley G, van Leth F, Lange C, Dominguez J. Use and impact of molecular methods for detecting drug-resistant TB. Int J Tuberc Lung Dis 2021; 25:157-159. [PMID: 33656431 DOI: 10.5588/ijtld.20.0527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- B Molina-Moya
- Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias (CIBERES), Badalona, Spain
| | - L Guglielmetti
- Unité 1135, Institut National de la Santé et de la Recherche Médicale, Centre d'Immunologie et des Maladies Infectieuses, Sorbonne Université, Paris, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Hôpital Pitié-Salpêtrière, Groupe Hospitalier Universitaire Sorbonne Université, Assistanve Publique-Hôpitaux de Paris, Paris, France
| | - G Bothamley
- Department of Respiratory Medicine, Homerton University Hospital, Queen Mary University, London, London School of Hygiene & Tropical Medicine, London, UK
| | - F van Leth
- Department of Global Health, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands
| | - C Lange
- Divisions of Clinical Infectious Diseases, Research Center Borstel, German Center for Infection Research (DZIF), Clinical Tuberculosis Unit, Borstel, Respiratory Medicine & International Health, University of Lübeck, Lübeck, Germany
| | - J Dominguez
- Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias (CIBERES), Badalona, Spain
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5
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Molina-Moya B, Ciobanu N, Hernandez M, Prat-Aymerich C, Crudu V, Adams ER, Codreanu A, Sloan DJ, Cuevas LE, Dominguez J. Molecular Detection of Mycobacterium tuberculosis in Oral Mucosa from Patients with Presumptive Tuberculosis. J Clin Med 2020; 9:jcm9124124. [PMID: 33371314 PMCID: PMC7767357 DOI: 10.3390/jcm9124124] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/04/2020] [Accepted: 12/16/2020] [Indexed: 01/29/2023] Open
Abstract
Tuberculosis (TB) diagnosis is increasingly based on the detection of Mycobacterium tuberculosis complex (MTBC) DNA in sputum using molecular diagnostic tests as the first test for diagnosis. However, sputum can be difficult to obtain in children, patients without productive cough, and the elderly and approaches testing non-sputum samples are needed. We evaluated whether TB can be detected from the oral mucosa of patients with TB. Adults with presumptive TB were examined using culture, Xpert MTB/RIF, smear microscopy and X-Rays. Oral mucosa swabs collected on PrimeStore-MTM, stored at room temperature if tested within 30 days or at -20 °C if examined at a later time. RT-PCR was performed to detect M. tuberculosis DNA. Eighty patients had bacteriologically-confirmed TB, 34 had bacteriologically-negative TB (negative tests but abnormal X-rays) and 152 were considered not to have TB (not TB). Oral swabs RT-PCR were positive in 29/80 (36.3%) bacteriologically-confirmed, 9/34 (26.5%) bacteriologically-negative and 29/152 (19.1%) not TB. The yield varied among samples stored for less and more than 30 days (p = 0.013) from 61% (11/18) and 29% (18/62) among bacteriologically confirmed, and 30.8% (4/13) and 23.8% (5/21) among bacteriologically-negative participants. Among not TB patients, the specificity was 80.9% (123/152), being 78.3% (18/23) among samples stored less than 30 days and 81.4% (105/129) among samples stored for more than 30 days (p = 0.46). The detection of M. tuberculosis in oral mucosa samples is feasible, but storage conditions may affect the yield.
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Affiliation(s)
- Barbara Molina-Moya
- Institut d’Investigació Germans Trias i Pujol, CIBER Enfermedades Respiratorias (CIBERES), Carretera del Canyet s/n, Camí de les Escoles s/n, Badalona, 08916 Barcelona, Spain; (B.M.-M.); (C.P.-A.)
- Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Carretera del Canyet s/n Badalona, 08916 Barcelona, Spain;
| | - Nelly Ciobanu
- Institutia Medico-Sanitara Publica, Institutul de Ftiziopneumologie “Chiril Draganiuc”, Strada Constantin Vârnav 13, 2025 Chișinău, Moldova; (N.C.); (V.C.); (A.C.)
| | - Marta Hernandez
- Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Carretera del Canyet s/n Badalona, 08916 Barcelona, Spain;
| | - Cristina Prat-Aymerich
- Institut d’Investigació Germans Trias i Pujol, CIBER Enfermedades Respiratorias (CIBERES), Carretera del Canyet s/n, Camí de les Escoles s/n, Badalona, 08916 Barcelona, Spain; (B.M.-M.); (C.P.-A.)
- Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Carretera del Canyet s/n Badalona, 08916 Barcelona, Spain;
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG Utrecht, The Netherlands
| | - Valeriu Crudu
- Institutia Medico-Sanitara Publica, Institutul de Ftiziopneumologie “Chiril Draganiuc”, Strada Constantin Vârnav 13, 2025 Chișinău, Moldova; (N.C.); (V.C.); (A.C.)
| | - Emily R. Adams
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK; (E.R.A.); (L.E.C.)
| | - Alexandru Codreanu
- Institutia Medico-Sanitara Publica, Institutul de Ftiziopneumologie “Chiril Draganiuc”, Strada Constantin Vârnav 13, 2025 Chișinău, Moldova; (N.C.); (V.C.); (A.C.)
| | - Derek J. Sloan
- School of Medicine, University of St Andrews, North Haugh, St Andrews KY16 9TF, UK;
| | - Luis E. Cuevas
- Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK; (E.R.A.); (L.E.C.)
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
| | - Jose Dominguez
- Institut d’Investigació Germans Trias i Pujol, CIBER Enfermedades Respiratorias (CIBERES), Carretera del Canyet s/n, Camí de les Escoles s/n, Badalona, 08916 Barcelona, Spain; (B.M.-M.); (C.P.-A.)
- Departament de Genètica i Microbiologia, Universitat Autònoma de Barcelona, Carretera del Canyet s/n Badalona, 08916 Barcelona, Spain;
- Correspondence: ; Tel.: +34-93-033-0537
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6
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Lange C, Aarnoutse RE, Alffenaar JWC, Bothamley G, Brinkmann F, Costa J, Chesov D, van Crevel R, Dedicoat M, Dominguez J, Duarte R, Grobbel HP, Günther G, Guglielmetti L, Heyckendorf J, Kay AW, Kirakosyan O, Kirk O, Koczulla RA, Kudriashov GG, Kuksa L, van Leth F, Magis-Escurra C, Mandalakas AM, Molina-Moya B, Peloquin CA, Reimann M, Rumetshofer R, Schaaf HS, Schön T, Tiberi S, Valda J, Yablonskii PK, Dheda K. Management of patients with multidrug-resistant tuberculosis. Int J Tuberc Lung Dis 2019; 23:645-662. [DOI: 10.5588/ijtld.18.0622] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- C. Lange
- Please see Supplementary Data for details of all author affiliations
| | - R. E. Aarnoutse
- Please see Supplementary Data for details of all author affiliations
| | | | - G. Bothamley
- Please see Supplementary Data for details of all author affiliations
| | - F. Brinkmann
- Please see Supplementary Data for details of all author affiliations
| | - J. Costa
- Please see Supplementary Data for details of all author affiliations
| | - D. Chesov
- Please see Supplementary Data for details of all author affiliations
| | - R. van Crevel
- Please see Supplementary Data for details of all author affiliations
| | - M. Dedicoat
- Please see Supplementary Data for details of all author affiliations
| | - J. Dominguez
- Please see Supplementary Data for details of all author affiliations
| | - R. Duarte
- Please see Supplementary Data for details of all author affiliations
| | - H. P. Grobbel
- Please see Supplementary Data for details of all author affiliations
| | - G. Günther
- Please see Supplementary Data for details of all author affiliations
| | - L. Guglielmetti
- Please see Supplementary Data for details of all author affiliations
| | - J. Heyckendorf
- Please see Supplementary Data for details of all author affiliations
| | - A. W. Kay
- Please see Supplementary Data for details of all author affiliations
| | - O. Kirakosyan
- Please see Supplementary Data for details of all author affiliations
| | - O. Kirk
- Please see Supplementary Data for details of all author affiliations
| | - R. A. Koczulla
- Please see Supplementary Data for details of all author affiliations
| | - G. G. Kudriashov
- Please see Supplementary Data for details of all author affiliations
| | - L. Kuksa
- Please see Supplementary Data for details of all author affiliations
| | - F. van Leth
- Please see Supplementary Data for details of all author affiliations
| | - C. Magis-Escurra
- Please see Supplementary Data for details of all author affiliations
| | - A. M. Mandalakas
- Please see Supplementary Data for details of all author affiliations
| | - B. Molina-Moya
- Please see Supplementary Data for details of all author affiliations
| | - C. A. Peloquin
- Please see Supplementary Data for details of all author affiliations
| | - M. Reimann
- Please see Supplementary Data for details of all author affiliations
| | - R. Rumetshofer
- Please see Supplementary Data for details of all author affiliations
| | - H. S. Schaaf
- Please see Supplementary Data for details of all author affiliations
| | - T. Schön
- Please see Supplementary Data for details of all author affiliations
| | - S. Tiberi
- Please see Supplementary Data for details of all author affiliations
| | - J. Valda
- Please see Supplementary Data for details of all author affiliations
| | - P. K. Yablonskii
- Please see Supplementary Data for details of all author affiliations
| | - K. Dheda
- Please see Supplementary Data for details of all author affiliations
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7
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Molina-Moya B, Abdurrahman ST, Madukaji LI, Gomgnimbou MK, Spinasse L, Gomes-Fernandes M, Gomes HM, Kacimi S, Dacombe R, Bimba JS, Lawson L, Sola C, Cuevas LE, Dominguez J. Genetic characterization of Mycobacterium tuberculosis complex isolates circulating in Abuja, Nigeria. Infect Drug Resist 2018; 11:1617-1625. [PMID: 30319278 PMCID: PMC6171509 DOI: 10.2147/idr.s166986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective Nigeria ranks fourth among the high tuberculosis (TB) burden countries. This study describes the prevalence of drug resistance and the genetic diversity of Mycobacterium tuberculosis in Abuja’s Federal Capital Territory. Materials and methods Two hundred and seventy-eight consecutive sputum samples were collected from adults with presumptive TB during 2013–2014. DNA was extracted from Löwenstein–Jensen cultures and analyzed for the identification of nontuberculous mycobacteria species, detection of drug resistance with line probe assays, and high-throughput spacer oligonucleotide typing (spoligotyping) using microbead-based hybridization. Results Two hundred and two cultures were positive for M. tuberculosis complex, 24 negative, 38 contaminated, and 15 positive for nontuberculous mycobacteria. Five (2.5%) M. tuberculosis complex isolates were resistant to rifampicin (RIF) and isoniazid (multidrug resistant), nine (4.5%) to RIF alone, and 15 (7.4%) to isoniazid alone; two RIF-resistant isolates were also resistant to fluoroquinolones and ethambutol, and one multidrug resistant isolate was also resistant to ethambutol. Among the 180 isolates with spoligotyping results, 164 (91.1%) were classified as lineage 4 (Euro-American), 13 (7.2%) as lineage 5 (West African 1), two (1.1%) as lineage 2 (East Asia), and one (0.6%) as lineage 6 (West African 2). One hundred and fifty-six (86.7%) isolates were grouped in 17 clusters (2–108 isolates/cluster), of which 108 (60.0%) were grouped as L4.6.2/Cameroon (spoligotype international type 61). Conclusion The description of drug resistance prevalence and genetic diversity of M. tuberculosis in this study may be useful for improving TB control in Nigeria.
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Affiliation(s)
- Barbara Molina-Moya
- Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain, .,CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain,
| | | | | | - Michel Kiréopori Gomgnimbou
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Univ. Paris-Sud, Université Paris-Saclay, Gif-sur-Yvette cedex, France.,Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Lizania Spinasse
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Univ. Paris-Sud, Université Paris-Saclay, Gif-sur-Yvette cedex, France
| | - Meissiner Gomes-Fernandes
- Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain, .,CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain, .,CAPES Foundation, Ministry of Education of Brazil, Brasília, Brazil
| | - Harrison Magdinier Gomes
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Univ. Paris-Sud, Université Paris-Saclay, Gif-sur-Yvette cedex, France
| | - Sarah Kacimi
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Univ. Paris-Sud, Université Paris-Saclay, Gif-sur-Yvette cedex, France
| | | | | | | | - Christophe Sola
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Univ. Paris-Sud, Université Paris-Saclay, Gif-sur-Yvette cedex, France
| | - Luis E Cuevas
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Jose Dominguez
- Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain, .,CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain,
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8
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Santos VS, Goletti D, Kontogianni K, Adams ER, Molina-Moya B, Dominguez J, Crudu V, Martins-Filho PRS, Ruhwald M, Lawson L, Bimba JS, Garcia-Basteiro AL, Petrone L, Kabeer BS, Reither K, Cuevas LE. Acute phase proteins and IP-10 as triage tests for the diagnosis of tuberculosis: systematic review and meta-analysis. Clin Microbiol Infect 2018; 25:169-177. [PMID: 30076971 DOI: 10.1016/j.cmi.2018.07.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/26/2018] [Accepted: 07/18/2018] [Indexed: 01/23/2023]
Abstract
OBJECTIVES We examined the data reported in studies for diagnostic purposes and to discuss whether their intended use could be extended to triage, as rule-in or rule-out tests to select individuals who should undergo further confirmatory tests. METHODS We searched Scopus, PubMed and Web of Science with the terms 'acute phase proteins,' 'IP-10,' 'tuberculosis,' 'screening' and 'diagnosis,' extracted the sensitivity and specificity of the biomarkers and explored methodologic differences to explain performance variations. Summary estimates were calculated using random-effects models for overall pooled accuracy. The hierarchical summary receiver operating characteristic model was used for meta-analysis. RESULTS We identified 14, four and one studies for C-reactive protein (CRP), interferon γ-induced protein 10 (IP-10) and alpha-1-acid glycoprotein (AGP). The pooled CRP sensitivity/specificity (95% confidence interval) was 89% (80-96) and 57% (36-65). Sensitivity/specificity were higher in high-tuberculosis-burden countries (90%/64%), HIV-infected individuals (91%/61%) and community-based studies (90%/62%). IP-10 sensitivity/specificity in TB vs. non-TB studies was 85%/63% and in TB and HIV coinfected vs. other lung conditions 94%/21%. However, IP-10 studies included diverse populations and a high risk of bias, resulting in very low-quality evidence. AGP had 86%/93% sensitivity/specificity. CONCLUSIONS Few studies have evaluated CRP, IP-10 and AGP for the triage of symptomatic patients. Their high sensitivity and moderate specificity warrant further prospective studies exploring whether their combined use could optimize performance.
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Affiliation(s)
- V S Santos
- Centre for Epidemiology and Public Health, Federal University of Alagoas, Arapiraca, Brazil
| | - D Goletti
- Department of Clinical and Clinical Research, 'L. Spallanzani' National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - K Kontogianni
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - E R Adams
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - B Molina-Moya
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain
| | - J Dominguez
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain
| | - V Crudu
- National TB Reference Laboratory, Phthisiopneumology Institute 'Chiril Draganiuc,' Chişinău, Republic of Moldova
| | - P R S Martins-Filho
- Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, Brazil
| | - M Ruhwald
- Center for Vaccine Research, Statens Serum Institut, Copenhagen, Denmark
| | - L Lawson
- Zankli Research Laboratory, Bingham University, Nassarawa State, Nigeria
| | - J S Bimba
- Zankli Research Laboratory, Bingham University, Nassarawa State, Nigeria
| | - A L Garcia-Basteiro
- Centro de Investigação em Saude de Manhiça (CISM), Rua 12, Cambeve CP 1929, Maputo, Mozambique; Amsterdam Institute for Global Health (AIGHD), Amsterdam, The Netherlands; Barcelona Institute for Global Health (ISGLobal), Barcelona, Spain
| | - L Petrone
- Department of Clinical and Clinical Research, 'L. Spallanzani' National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - B S Kabeer
- Department of Clinical and Clinical Research, 'L. Spallanzani' National Institute for Infectious Diseases (INMI), IRCCS, Rome, Italy
| | - K Reither
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - L E Cuevas
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
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9
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Kazdaglis G, Molina-Moya B, Manika K, Ioannidis P, Papaventsis D, Vogiatzakis E, Panopoulou M, Melidou A, Domínguez J, Malisiovas N, Gioula G. Genetic diversity of mycobacterium tuberculosis in northern Greece. J BIOL REG HOMEOS AG 2018; 32:931-936. [PMID: 30043579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aim of the present study was to describe the genetic diversity of Mycobacterium tuberculosis (M.tuberculosis) strains circulating in the region of Northern Greece. A total of thirty-seven M. tuberculosis clinical isolates were analysed by the spoligotyping method. According to the results, six clusters comprising seventeen strains were detected, and the remaining twenty strains showed unique patterns. The M.tuberculosis families according to SITVITWEB were distributed as follows: Haarlem (H) (27.0%); T (24.3%); Beijing (13.5%); Latin-America and Mediterranean (LAM) (5.4%) and S (2.7%). The remaining isolates (27%) did not match any isolates within the database and they were characterized as orphans. Regarding GenoType MTBDRplus results, two strains (5.4%) were Multi-Drug-Resistant, four strains (10.8%), were isoniazid monoresistant, while the remaining thirty-one strains (83.8%) were susceptible. In conclusion, in the region of Macedonia-Thrace (Northern Greece), there was high phylogenetic diversity among M. tuberculosis isolates. Molecular tools used and data presented can have regional and national impact on tuberculosis control.
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Affiliation(s)
- G Kazdaglis
- Microbiology Department, Medical School, Aristotle University of Thessaloniki, Greece
| | - B Molina-Moya
- Microbiology Laboratory, University Hospital Germans Trias i Pujol, Institute of Investigation Germans Trias i Pujol, Badalona, Autonomous University of Barcelona, CIBERES, Spain
| | - K Manika
- Pulmonary Department, Aristotle University of Thessaloniki, G. Papanikolaou Hospital, Greece
| | - P Ioannidis
- Microbiology Laboratory and National Reference Center for TB, Sotiria Chest Diseases Hospital, Athens, Greece
| | - D Papaventsis
- Microbiology Laboratory and National Reference Center for TB, Sotiria Chest Diseases Hospital, Athens, Greece
| | - E Vogiatzakis
- Microbiology Laboratory and National Reference Center for TB, Sotiria Chest Diseases Hospital, Athens, Greece
| | - M Panopoulou
- Microbiology Department, Medical School, Democritus University of Thrace, Greece
| | - A Melidou
- Microbiology Department, Medical School, Aristotle University of Thessaloniki, Greece
| | - J Domínguez
- Microbiology Laboratory, University Hospital Germans Trias i Pujol, Institute of Investigation Germans Trias i Pujol, Badalona, Autonomous University of Barcelona, CIBERES, Spain
| | - N Malisiovas
- Microbiology Department, Medical School, Aristotle University of Thessaloniki, Greece
| | - G Gioula
- Microbiology Department, Medical School, Aristotle University of Thessaloniki, Greece
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10
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Klotoe BJ, Molina-Moya B, Gomes HM, Gomgnimbou MK, Oliveira Suzarte L, Féres Saad MH, Ali S, Dominguez J, Pimkina E, Zholdybayeva E, Sola C, Refrégier G. TB-EFI, a novel 18-Plex microbead-based method for prediction of second-line drugs and ethambutol resistance in Mycobacterium tuberculosis complex. J Microbiol Methods 2018; 152:10-17. [PMID: 29913189 DOI: 10.1016/j.mimet.2018.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 06/12/2018] [Accepted: 06/13/2018] [Indexed: 10/28/2022]
Abstract
Several diagnostic tests are being developed to detect drug resistance in tuberculosis. In line with previous developments detecting rifampicin and isoniazid resistance using microbead-based systems (spoligoriftyping and TB-SPRINT), we present here an assay called TB-EFI detecting mutations involved in resistance to ethambutol, fluoroquinolones and the three classical injectable drugs (kanamycin, amikacin and capreomycin) in Mycobacterium tuberculosis. The proposed test includes both wild-type and mutant probes for each targeted locus. Basic analysis can be performed manually. An upgraded interpretation is made available in Excel 2016®. Using a reference set of 61 DNA extracts, we show that TB-EFI provides perfect concordance with pyrosequencing. Concordance between genotypic resistance and phenotypic DST was relatively good (72 to 98% concordance), with lower efficiency for fluoroquinolones and ethambutol due to some untargeted mutations. When compared to phenotypical resistance, performances were similar to those obtained with Hain MTBDRsl assay, possibly thanks to the use of automatized processing of data although some mutations involved in fluoroquinolone resistance could not be included. When applied on three uncharacterized sets, phenotype could be predicted for 51% to 98% depending on the setting and the drug investigated, detecting one extensively drug-resistant isolate in each of a Pakistan and a Brazilian set of 91 samples, and 9 XDR among 43 multi-resistant Kazakhstan samples. By allowing high-throughput detection of second-line drugs resistance and of resistance to ethambutol that is often combined to second-line treatments, TB-EFI is a cost-effective assay for large-scale worldwide surveillance of resistant tuberculosis and XDR-TB control.
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Affiliation(s)
- Bernice J Klotoe
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Univ. Paris-Sud, Université Paris-Saclay, 91198, Gif-sur-Yvette cedex, France
| | - Barbara Molina-Moya
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autonoma de Barcelona, Badalona, Spain
| | - Harrison Magdinier Gomes
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Univ. Paris-Sud, Université Paris-Saclay, 91198, Gif-sur-Yvette cedex, France; Laboratório de Biologia Molecular Aplicada à Micobactérias, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Michel K Gomgnimbou
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Univ. Paris-Sud, Université Paris-Saclay, 91198, Gif-sur-Yvette cedex, France; Centre Muraz, Bobo-Dioulasso, Burkina Faso; Univ. Polytech, Bobo-Dioulasso, Burkina Faso
| | - Lorenna Oliveira Suzarte
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Univ. Paris-Sud, Université Paris-Saclay, 91198, Gif-sur-Yvette cedex, France
| | - Maria H Féres Saad
- Laboratório de Microbiologia Celular, Instituto Oswaldo Cruz, Av. Brasil, 4365 - 20245, Rio de Janeiro, Brazil
| | - Sajid Ali
- Microbiology Department, Quaid-i-Azam University, Islamabad, Pakistan
| | - José Dominguez
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autonoma de Barcelona, Badalona, Spain
| | - Edita Pimkina
- Infectious Diseases and Tuberculosis Hospital, Affiliate of Vilnius University Hospital Santariskiu klinikos, Vilnius, Lithuania
| | - Elena Zholdybayeva
- National Center for Biotechnology, Astana, Kazakhstan; Universitat Autònoma de Barcelona. CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - Christophe Sola
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Univ. Paris-Sud, Université Paris-Saclay, 91198, Gif-sur-Yvette cedex, France.
| | - Guislaine Refrégier
- Institute for Integrative Biology of the Cell (I2BC), CEA, CNRS, Univ. Paris-Sud, Université Paris-Saclay, 91198, Gif-sur-Yvette cedex, France.
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11
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Burman M, Nikolayevskyy V, Kontsevaya I, Molina-Moya B, Rzhepishevska O, Guglielmetti L. Tackling the MDR-TB epidemic in Ukraine: every little helps … and much more needed. J Public Health (Oxf) 2018; 40:210-211. [DOI: 10.1093/pubmed/fdx014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 01/25/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Matthew Burman
- Centre for Primary Care and Public Health, Queen Mary University of London,London,UK
| | - Vladyslav Nikolayevskyy
- Public Health England, National Mycobacterium Reference Service South, London, UK
- Imperial College, London, UK
| | - Irina Kontsevaya
- Department of Medicine, Infectious Diseases and Immunity, Imperial College London, London, UK
| | - Barbara Molina-Moya
- Institut Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona, Barcelona,Spain
| | | | - Lorenzo Guglielmetti
- Centre Hospitalier de Bligny, Briis-sous-Forges, France
- Center of Immunology and Infectious Diseases, Sorbonne Université, Paris, France
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12
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Molina-Moya B, Lacoma A, García-Sierra N, Blanco S, Haba L, Samper S, Ruiz-Manzano J, Prat C, Arnold C, Domínguez J. PyroTyping, a novel pyrosequencing-based assay for Mycobacterium tuberculosis genotyping. Sci Rep 2017; 7:6777. [PMID: 28754991 PMCID: PMC5533701 DOI: 10.1038/s41598-017-06760-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 06/19/2017] [Indexed: 11/09/2022] Open
Abstract
We developed a novel method, PyroTyping, for discrimination of Mycobacterium tuberculosis isolates combining pyrosequencing and IS6110 polymorphism. A total of 100 isolates were analysed with IS6110-restriction fragment length polymorphism (RFLP), spoligotyping, mycobacterial interspersed repetitive units - variable number tandem repeats (MIRU-VNTR), and PyroTyping. PyroTyping results regarding clustering or discrimination of the isolates were highly concordant with the other typing methods performed. PyroTyping is more rapid than RFLP and presents the same discriminatory power, thus, it may be useful for taking timely decisions for tuberculosis control.
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Affiliation(s)
- B Molina-Moya
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - A Lacoma
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - N García-Sierra
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain
| | - S Blanco
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - L Haba
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain
| | - S Samper
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Instituto Aragonés de Ciencias de la Salud, Zaragoza, 50009, Spain.,Fundación Instituto de Investigación Sanitaria de Aragón, Zaragoza, 50009, Spain
| | - J Ruiz-Manzano
- Servei de Pneumologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - C Prat
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - C Arnold
- Genomic Services and Development Unit, Public Health England, 61 Colindale Avenue, London, United Kingdom
| | - J Domínguez
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain. .,CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, 28029, Spain.
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13
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Molina-Moya B, Gomgnimbou MK, Lafoz C, Lacoma A, Prat C, Refrégier G, Samper S, Dominguez J, Sola C. Molecular Characterization of Mycobacterium tuberculosis Strains with TB-SPRINT. Am J Trop Med Hyg 2017; 97:806-809. [PMID: 28722603 DOI: 10.4269/ajtmh.16-0782] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We evaluated Tuberculosis-Spoligo-Rifampicin-Isoniazid Typing (TB-SPRINT), a microbead-based method for spoligotyping and detection of rifampicin and isoniazid resistance in Mycobacterium tuberculosis. For that, 67 M. tuberculosis complex strains were retrospectively selected. Membrane-based spoligotyping, restriction fragment length polymorphism, DNA sequencing/pyrosequencing of rpoB, katG, and inhA promoter, TB-SPRINT, and SNP typing were performed. Concordance between spoligotyping methods was 99.6% (2,785/2,795 spoligotype data points). For most of the discordant cases, the same lineage was assigned with both methods. Concordance between phenotypic drug susceptibility testing and TB-SPRINT for detecting rifampicin and isoniazid resistance was 98.4% (63/64) and 93.8% (60/64), respectively. Concordance between DNA sequencing/pyrosequencing and TB-SPRINT for detecting mutations in rpoB, katG, and inhA were 98.4% (60/61), 100% (64/64), and 96.9% (62/64), respectively. In conclusion, TB-SPRINT is a rapid and easy-to-perform assay for genotyping and detecting drug resistance in a single tube; therefore, it may be a useful tool to improve epidemiological surveillance.
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Affiliation(s)
- Barbara Molina-Moya
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.,Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Michel Kiréopori Gomgnimbou
- Centre Muraz, Bobo-Dioulasso, Burkina Faso.,Institut de Biologie Intégrative de la Cellule (I2BC), CEA, CNRS, Université Paris-Sud, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Carmen Lafoz
- Instituto Aragonés de Ciencias de la Salud, Fundación Instituto de Investigación Sanitaria de Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Alicia Lacoma
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.,Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Cristina Prat
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.,Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Guislaine Refrégier
- Institut de Biologie Intégrative de la Cellule (I2BC), CEA, CNRS, Université Paris-Sud, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Sofia Samper
- Instituto Aragonés de Ciencias de la Salud, Fundación Instituto de Investigación Sanitaria de Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain.,CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose Dominguez
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.,Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Christophe Sola
- Institut de Biologie Intégrative de la Cellule (I2BC), CEA, CNRS, Université Paris-Sud, Université Paris-Saclay, Gif-sur-Yvette, France
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14
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Obasanya J, Lawson L, Edwards T, Olanrewaju O, Madukaji L, Dacombe R, Dominguez J, Molina-Moya B, Adams ER, Cuevas LE. FluoroType MTB system for the detection of pulmonary tuberculosis. ERJ Open Res 2017; 3:00113-2016. [PMID: 28491868 PMCID: PMC5420815 DOI: 10.1183/23120541.00113-2016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 03/11/2017] [Indexed: 11/16/2022] Open
Abstract
Diagnosis continues to be a major barrier for the control of tuberculosis (TB), especially in low- and middle-income countries (LMIC) [1]. The number of platforms for the molecular diagnosis of TB have increased in recent years and they can provide test results more rapidly than culture. Molecular assays are increasingly being used as alternative or adjunct methods to culture and smear microscopy, and modern systems seek to partially or fully automate the DNA extraction and amplification steps, increasing their suitability for resource-limited laboratories. One of these platforms, the GeneXpert MTB/RIF (Cepheid, USA), has a sensitivity of roughly 85% compared to culture [2] and has seen significant uptake in developing countries [3]. However, as a fully closed system, the DNA extracted during the process cannot be used for further downstream drug susceptibility testing (DST), which is crucial for patients with suspected drug-resistant TB. FluoroType MTB is a sensitive test for TB but specificity is low compared with fully integrated molecular systemshttp://ow.ly/WhEO30b1luY
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Affiliation(s)
| | - Lovett Lawson
- Zankli Research Laboratory, Dept of Community Medicine and Primary Healthcare, Bingham University, Karu, Nigeria.,Zankli Medical Center, Abuja, Nigeria
| | - Thomas Edwards
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Laura Madukaji
- Zankli Research Laboratory, Dept of Community Medicine and Primary Healthcare, Bingham University, Karu, Nigeria
| | - Russell Dacombe
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Jose Dominguez
- Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias (CIBERES), Badalona, Spain
| | - Barbara Molina-Moya
- Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, CIBER Enfermedades Respiratorias (CIBERES), Badalona, Spain
| | - Emily R Adams
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Luis E Cuevas
- Research Centre for Drugs and Diagnostics, Liverpool School of Tropical Medicine, Liverpool, UK
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Domínguez J, Boettger EC, Cirillo D, Cobelens F, Eisenach KD, Gagneux S, Hillemann D, Horsburgh R, Molina-Moya B, Niemann S, Tortoli E, Whitelaw A, Lange C. Clinical implications of molecular drug resistance testing for Mycobacterium tuberculosis: a TBNET/RESIST-TB consensus statement. Int J Tuberc Lung Dis 2016; 20:24-42. [DOI: 10.5588/ijtld.15.0221] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lacoma A, Molina-Moya B, Prat C, Pimkina E, Diaz J, Dudnyk A, García-Sierra N, Haba L, Maldonado J, Samper S, Ruiz-Manzano J, Ausina V, Dominguez J. Pyrosequencing for rapid detection of Mycobacterium tuberculosis second-line drugs and ethambutol resistance. Diagn Microbiol Infect Dis 2015; 83:263-9. [PMID: 26256417 DOI: 10.1016/j.diagmicrobio.2015.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 07/06/2015] [Accepted: 07/07/2015] [Indexed: 01/08/2023]
Abstract
The aim of this work was to study the diagnostic accuracy of pyrosequencing to detect resistance to fluoroquinolones, kanamycin, amikacin, capreomycin, and ethambutol (EMB) in Mycobacterium tuberculosis clinical strains. One hundred four clinical isolates previously characterized by BACTEC 460TB/MGIT 960 were included. Specific mutations were targeted in gyrA, rrs, eis promoter, and embB. When there was a discordant result between BACTEC and pyrosequencing, Genotype MTBDRsl (Hain Lifescience, Nehren, Germany) was performed. Sensitivity and specificity of pyrosequencing were 70.6% and 100%, respectively, for fluoroquinolones; 93.3% and 81.7%, respectively, for kanamycin; 94.1% and 95.9%, respectively, for amikacin; 90.0% and 100%, respectively, for capreomycin; and 64.8% and 87.8%, respectively, for EMB. This study shows that pyrosequencing may be a useful tool for making early decisions regarding second-line drugs and EMB resistance. However, for a correct management of patients with suspected extensively drug-resistant tuberculosis, susceptibility results obtained by molecular methods should be confirmed by a phenotypic method.
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Affiliation(s)
- Alicia Lacoma
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - Barbara Molina-Moya
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - Cristina Prat
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - Edita Pimkina
- Infectious Diseases and Tuberculosis Hospital, Affiliate of Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania
| | - Jessica Diaz
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - Andriy Dudnyk
- Department of Tuberculosis, Clinical Immunology and Allergology, Vinnitsa National Pirogov Memorial Medical University, Vinnitsa, Ukraine
| | - Nerea García-Sierra
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain
| | - Lucía Haba
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain
| | | | - Sofia Samper
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain; Instituto Aragonés de Ciencias de la Salud, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Juan Ruiz-Manzano
- Servei de Pneumologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - Vicente Ausina
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - Jose Dominguez
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916, Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain.
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Molina-Moya B, Lacoma A, Prat C, Pimkina E, Diaz J, García-Sierra N, Haba L, Maldonado J, Samper S, Ruiz-Manzano J, Ausina V, Dominguez J. Diagnostic accuracy study of multiplex PCR for detecting tuberculosis drug resistance. J Infect 2015; 71:220-30. [PMID: 25936742 DOI: 10.1016/j.jinf.2015.03.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 03/05/2015] [Accepted: 03/09/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To study the diagnostic accuracy of a multiplex real-time PCR (Anyplex II MTB/MDR/XDR, Seegene, Corea) that detects Mycobacterium tuberculosis resistant to isoniazid (INH), rifampicin (RIF), fluoroquinolones (FLQ) and injectable drugs (kanamycin [KAN], amikacin [AMK] and capreomycin [CAP]) in isolates and specimens. METHODS One hundred fourteen cultured isolates and 73 sputum specimens were retrospectively selected. Results obtained with multiplex PCR were compared with those obtained with BACTEC. Discordant results between multiplex PCR and BACTEC were tested by alternative molecular methods. RESULTS Sensitivity and specificity of multiplex PCR for detecting drug resistance in isolates were 76.5% and 100%, respectively, for INH; 97.2% and 96.0%, respectively, for RIF; 70.4% and 87.9%, respectively, for FLQ; 81.5% and 84.8%, respectively, for KAN; 100% and 60%, respectively, for AMK, and 100% and 72.3%, respectively, for CAP. Sensitivity and specificity of Anyplex for detecting drug resistance in specimens were 93.3% and 100%, respectively, for INH; 100% and 100%, respectively, for RIF; 50.0% and 100%, respectively, for FLQ; and 100% and 94.4%, respectively, for both KAN and CAP. Among the discordant results, 87.7% (71/81) of results obtained with the multiplex PCR were concordant with at least one of the alternative molecular methods. CONCLUSIONS This multiplex PCR may be a useful tool for the rapid identification of drug resistant tuberculosis in isolates and specimens, thus allowing an initial therapeutic approach. Nevertheless, for a correct management of patients, results should be confirmed by a phenotypic method.
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Affiliation(s)
- B Molina-Moya
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - A Lacoma
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - C Prat
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - E Pimkina
- Infectious Diseases and Tuberculosis Hospital, Affiliate of Vilnius University Hospital Santariskiu klinikos, Vilnius, Lithuania
| | - J Diaz
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - N García-Sierra
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain
| | - L Haba
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain
| | | | - S Samper
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain; Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - J Ruiz-Manzano
- Servei de Pneumologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - V Ausina
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - J Dominguez
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain.
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Molina-Moya B, Lacoma A, Prat C, Diaz J, Dudnyk A, Haba L, Maldonado J, Samper S, Ruiz-Manzano J, Ausina V, Dominguez J. AID TB resistance line probe assay for rapid detection of resistant Mycobacterium tuberculosis in clinical samples. J Infect 2014; 70:400-8. [PMID: 25305498 DOI: 10.1016/j.jinf.2014.09.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 08/25/2014] [Accepted: 09/17/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To determine the sensitivity and specificity of AID TB Resistance line probe assay (AID Diagnostika, Germany) to detect Mycobacterium tuberculosis and its resistance to first- and second-line drugs in clinical samples using BACTEC 460TB as the reference standard. METHODS The test consists on three strips to detect resistance to isoniazid/rifampicin, fluoroquinolones/ethambutol, and kanamycin/amikacin/capreomycin/streptomycin, respectively. This test was performed on 65 retrospectively selected clinical samples corresponding to 32 patients. RESULTS A valid result was obtained for 92.3% (60/65), 90.8% (59/65) and 78.5% (51/65) of the samples tested, considering the three strips, respectively. Global concordance rates between AID and BACTEC for detecting resistance to isoniazid, rifampicin, fluoroquinolones, ethambutol, kanamycin/capreomycin and streptomycin were 98.3% (59/60), 100% (60/60), 91.5% (54/59), 72.9% (43/59), 100% (51/51) and 98.0% (50/51), respectively. Regarding the discordant results obtained between AID and BACTEC, the alternative molecular methods performed (GenoType MTBDRplus, GenoType MTBDRsl [Hain Lifescience, Germany] and/or pyrosequencing) confirmed the genotypic result in 90.9% (20/22) of the cases. CONCLUSIONS AID line probe assay is a useful tool for the rapid detection of drug resistance in clinical samples enabling an initial therapeutic approach. Nevertheless, for a correct management of drug resistant tuberculosis patients, molecular results should be confirmed by a phenotypic method.
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Affiliation(s)
- B Molina-Moya
- Servei de Microbiologia Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - A Lacoma
- Servei de Microbiologia Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - C Prat
- Servei de Microbiologia Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - J Diaz
- Servei de Microbiologia Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain
| | - A Dudnyk
- Department of Tuberculosis, Clinical Immunology and Allergology, Vinnitsa National Pirogov Memorial Medical University, Vinnitsa, Ukraine
| | - L Haba
- Servei de Microbiologia Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain
| | | | - S Samper
- CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain; Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - J Ruiz-Manzano
- Servei de Pneumologia, Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - V Ausina
- Servei de Microbiologia Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain
| | - J Dominguez
- Servei de Microbiologia Hospital Universitari Germans Trias i Pujol, Institut d'Investigació Germans Trias i Pujol, Universitat Autònoma de Barcelona, Carretera del Canyet s/n, 08916 Badalona, Spain; CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Spain.
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