1. Direct Susceptibility Testing of Mycobacterium Tuberculosis for Pyrazinamide using the BACTEC MGIT 960 System
- Author
-
Mohammed Sasamalo, Kathleen D. Eisenach, Daniel Everitt, Sven O. Friedrich, Mara Gibson, Levan Jugheli, Deepak V. Almeida, Daniel Mapamba, Anne-Marie Demers, Amour Venter, Gabriel Rojas-Ponce, Andreas H. Diacon, Ute Jentsch, and Afton Dorasamy
- Subjects
0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Susceptibility testing ,Time Factors ,Drug trial ,Drug-resistant TB ,030106 microbiology ,Antitubercular Agents ,Context (language use) ,Microbial Sensitivity Tests ,Sensitivity and Specificity ,Mycobacterium tuberculosis ,03 medical and health sciences ,Internal medicine ,Diagnosis ,medicine ,Humans ,biology ,business.industry ,Sputum ,Reproducibility of Results ,Mycobacteriology and Aerobic Actinomycetes ,Drug susceptibility ,Gold standard (test) ,Pyrazinamide ,biology.organism_classification ,Surgery ,Treatment ,030104 developmental biology ,medicine.symptom ,business ,medicine.drug - Abstract
Pyrazinamide (PZA) is a key antituberculosis drug, yet no rapid susceptibility test is commercially available. PZA drug susceptibility testing (DST) was performed directly on sputum samples from 327 patients and compared with the indirect method by using the Bactec MGIT 960 system in the context of patient screening for participation in a drug trial. Compared to standard indirect PZA DST, direct DST was successful in only 59% of cases, but results obtained were highly accurate and available faster. Agreement between the direct and indirect methods varied from 90 to 100% in each laboratory. The median times for obtaining PZA results from the time when the specimen was collected ranged from 11 to 16 days for the direct test and 18 to 95 days for the indirect test across laboratories. The direct method is accurate and reproducible across laboratories. It can be expected to accelerate results in >50% of cases, but it cannot replace indirect DST for PZA. Phenotypic methods remain the gold standard for DST in drug trials. If future studies can optimize the method to decrease the number of uninterpretable results, direct MGIT DST could be the new phenotypic DST standard for clinical trials, providing more rapid detection of resistance to new drugs in experimental regimens.
- Published
- 2016