Objectives: The reference standard methods for drug susceptibility testing (DST) of M. tuberculosis are very slow to give results, and due to the emergence of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis, there is an urgent demand for new, rapid and accurate DST methods, particularly in low-income countries. The nitrate reductase assay (NRA) has been proposed as a rapid method for the detection of resistance to rifampicin and isoniazid, but its accuracy has not been systematically evaluated.
Methods: We performed a systematic review and meta-analysis to evaluate the accuracy of the NRA for the detection of rifampicin- and isoniazid-resistant tuberculosis. We searched Medline PubMed (NCBI), Global Health-CAB, EJS-E (EbscoHost), ISI Web, Web of Science and IFCC and contacted authors if additional information was required. Fifteen studies met our inclusion criteria for rifampicin resistance detection and 13 for isoniazid. Of these, the majority of the studies used culture isolates on solid medium, four used culture isolates on liquid medium and three used sputum samples. We applied the summary receiver operating characteristic (SROC) curve to perform meta-analysis and to summarize diagnostic accuracy.
Results: For rifampicin, the majority of the studies that applied NRA to isolates had a sensitivity and specificity >94% and for isoniazid, >92%. The three studies that applied NRA directly on sputum samples had a sensitivity and specificity that ranged between 88% and 100%. The SROC curve had an area of >0.99 for both drugs.
Conclusions: There is evidence that NRA is highly sensitive and specific for the rapid detection of rifampicin and isoniazid resistance in culture isolates. More evidence is required for the NRA applied directly on sputum samples, but preliminary results appear promising and show a good sensitivity and specificity. Additional studies are required in countries with a high prevalence of MDR-TB and also cost-effectiveness analysis in order to obtain a complete picture on the utility of this method for rapid drug resistance detection in tuberculosis.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/jac/dkn139 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Molecular identification and antibiotic clearance of and from cell cultures infected with or species.
Microbiol Spectr
January 2025
Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services, Atlanta, Georgia, USA.
Mycoplasma (Class: Mollicutes) contamination in cell cultures is a universal concern for research laboratories. Some estimates report contamination in up to 35% of continuous cell lines. Various commercial antibiotic treatments can successfully decontaminate clean cell lines ; however, decontamination of bacterial cultures remains challenging.
View Article and Find Full Text PDFIdentification and Characterization of a Protease Producing Strain From Tannery Waste for Efficient Dehairing of Goat Skin.
Biomed Res Int
January 2025
Center for Personalized Nanomedicine, Australian Institute for Bioengineering & Nanotechnology (AIBN), The University of Queensland, Brisbane, Queensland, Australia.
Environmental pollution has been a significant concern for the last few years. The leather industry significantly contributes to the economy but is one of Bangladesh's most prominent polluting industries. It is also responsible for several severe diseases such as cancer, lung diseases, and heart diseases of leather workers because they use bleaching agents and chemicals, and these have numerous adverse effects on human health.
View Article and Find Full Text PDFMizagliflozin ameliorates diabetes induced kidney injury by inhibitor inhibit inflammation and oxidative stress.
World J Diabetes
January 2025
Department of Nephrology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China.
Background: Mizagliflozin (MIZ) is a specific inhibitor of sodium-glucose cotransport protein 1 (SGLT1) originally developed as a medication for diabetes.
Aim: To explore the impact of MIZ on diabetic nephropathy (DN).
Methods: Diabetic mice were created using db/db mice.
Transcriptome analysis reveals molecular targets of erythrocyte invasion phenotype diversity in natural isolates from Cameroon.
Front Parasitol
May 2024
Disease Control and Elimination (DCE), Medical Research Council The Gambia Unit at the London School of Hygiene and Tropical Medicine (LSHTM), Fajara, Gambia.
Further understanding of the molecular mediators of alternative RBC invasion phenotypes in endemic malaria parasites will support malaria blood-stage vaccine or drug development. This study investigated the prevalence of sialic acid (SA)-dependent and SA-independent RBC invasion pathways in endemic parasites from Cameroon and compared the schizont stage transcriptomes in these two groups to uncover the wider repertoire of transcriptional variation associated with the use of alternative RBC invasion pathway phenotypes. A two-color flow cytometry-based invasion-inhibition assay against RBCs treated with neuraminidase, trypsin, and chymotrypsin and deep RNA sequencing of schizont stages harvested in the first replication cycle in culture were employed in this investigation.
View Article and Find Full Text PDFTumor necrosis factor-alpha (TNF-α) inhibitors are commonly used for management of various autoimmune disorders but can rarely cause isolated cutaneous lupus. This report presents two cases of cutaneous lupus erythematosus (LE) in women aged 38 and 61 after adalimumab treatment for psoriasis highlighting the importance of recognizing these paradoxical reactions for timely management.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!