Prospective evaluation of thin-layer agar colour test in routine diagnosis of multidrug-resistant TB.

This study evaluated the diagnostic performance of the thin-layer agar MDR/XDR-TB Colour Test (CT), a complex (MTBC) detection and direct drug susceptibility testing (DST) method with routine sputum, bronchoalveolar lavage and pleural fluid specimen.In a prospective study, the time and rate of MTBC detection were compared between CT, Löwenstein-Jensen, and MGIT media. Times until DST result, sensitivities, and specificities were evaluated between CT and MGIT 960 indirect DST.

A successful introduction to a non-expert setting of the thin-layer agar Colour Test as an indirect phenotypic drug susceptibility test for Mycobacterium tuberculosis.

Objectives: We evaluated the performance of the MDR/XDR-TB Colour Test (CT) as an in-house thin-layer agar-based indirect drug susceptibility test (DST) for Mycobacterium tuberculosis (MTB) in a non-expert setting in Estonia.

Methods: After 2 days of hands-on training for laboratory technicians, 6 panels of 150 MTB isolates were cultured onto CT plates prepared in-house in 2 laboratories. Triplicate readings of 900 CT plates resulted in 18 DST patterns for each initial isolate.

Multidrug-Resistant Tuberculosis Treatment Outcomes in Relation to Treatment and Initial Versus Acquired Second-Line Drug Resistance.

Background: Resistance to second-line drugs develops during treatment of multidrug-resistant (MDR) tuberculosis, but the impact on treatment outcome has not been determined.

Methods: Patients with MDR tuberculosis starting second-line drug treatment were enrolled in a prospective cohort study. Sputum cultures were analyzed at a central reference laboratory.

A four-year nationwide molecular epidemiological study in Estonia: risk factors for tuberculosis transmission.

Setting: Estonia has a high proportion of multidrug-resistant tuberculosis (MDR-TB). It is important to link molecular and epidemiological data to understand TB transmission patterns.

Objective: To use 24-locus variable numbers of tandem repeat (VNTR) typing and national TB registry data in Estonia from 2009 to 2012 to identify the distribution of drug resistance patterns, Mycobacterium tuberculosis isolate clustering as an index for recent transmission, socio-demographic and clinical characteristics associated with recent transmission, and the distribution of transmission between index and secondary cases.

Extensive drug resistance acquired during treatment of multidrug-resistant tuberculosis.

Background: Increasing access to drugs for the treatment of multidrug-resistant (MDR) tuberculosis is crucial but could lead to increasing resistance to these same drugs. In 2000, the international Green Light Committee (GLC) initiative began to increase access while attempting to prevent acquired resistance.

Methods: To assess the GLC's impact, we followed adults with pulmonary MDR tuberculosis from the start to the end of treatment with monthly sputum cultures, drug susceptibility testing, and genotyping.