Background: Rapid tuberculosis (TB) drug susceptibility testing (DST) is crucial. Genotype MTBDRsl is a widely deployed World Health Organization (WHO)-endorsed assay. Programmatic performance data, including non-actionable results from smear-negative sputum, are scarce.
Methods: Sputa from Xpert MTB/RIF individuals (n = 951) were routinely-tested using Genotype MTBDRplus and MTBDRsl (both version 2). Phenotypic DST was the second-line drug reference standard. Discrepant results underwent Sanger sequencing.
Findings: 89% (849 of 951) of individuals were culture-positive (56%, 476 of 849 smear-negative). MTBDRplus had at least 1 nonactionable result (control and/or TB-detection bands absent or invalid, precluding resistance reporting) in 19% (92 of 476) of smear-negatives; for MTBDRsl, 40% (171 of 427) were nonactionable (28%, 120 of 427 false-negative TB; 17%, 51 of 427 indeterminate). In smear-negatives, MTBDRsl sensitivity for fluoroquinolones was 84% (95% confidence interval, 67%-93), 81% (54%-95%) for second-line injectable drugs, and 57% (28%-82%) for both. Specificities were 93% (89%-98%), 88% (81%-93%), and 97% (91%-99%), respectively. Twenty-three percent (172 of 746) of Xpert rifampicin-resistant specimens were MTBDRplus isoniazid-susceptible. Days-to-second-line-susceptibility reporting with the programmatic advent of MTBDRsl improved (6 [5-7] vs 37 [35-46]; P < .001).
Conclusions: MTBDRsl did not generate a result in 4 of 10 smear-negatives, resulting in substantial missed resistance. However, if MTBDRsl generates an actionable result, that is accurate in ruling-in resistance. Isoniazid DST remains crucial. This study provides real-world, direct, second-line susceptibility testing performance data on non-actionable results (that, if unaccounted for, cause an overestimation of test utility), accuracy, and care cascade impact.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7614164 | PMC |
| http://dx.doi.org/10.1093/cid/ciac556 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Antimicrobial resistance, virulence gene profiling, and genetic diversity of multidrug-resistant Pseudomonas aeruginosa isolates in Mazandaran, Iran.
BMC Microbiol
December 2024
Department of Microbiology and Virology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Background: Pseudomonas aeruginosa is a major cause of healthcare-associated infections (HAIs), particularly in immunocompromised patients, leading to high morbidity and mortality rates. This study aimed to investigate the antimicrobial resistance patterns, virulence gene profiles, and genetic diversity among P. aeruginosa isolates from hospitalized patients in Mazandaran, Iran.
View Article and Find Full Text PDFFemale collegiate soccer players post anterior cruciate ligament reconstruction utilize aberrant movement strategies to achieve similar performance to uninjured players.
Clin Biomech (Bristol)
December 2024
UGA Biomechanics Laboratory, Department of Kinesiology, University of Georgia, Athens, GA, USA.
Background: Female soccer athletes with a history of anterior cruciate ligament injury are more susceptible to secondary injuries and potentially worse sport performance. The purpose of this study was to determine if female soccer athletes post anterior cruciate ligament reconstruction demonstrate worse jump height and reactive strength index performance and lower involved limb hip, knee, and ankle joint power and absorption, and larger joint power and absorption asymmetries compared to matched uninjured athletes.
Methods: Eleven Division I female soccer athletes post anterior cruciate ligament reconstruction (18.
Fungi associated with orange juice production and assessment of adhesion ability and resistance to sanitizers.
Int J Food Microbiol
December 2024
Department of Food Science and Nutrition, Faculty of Food Engineering, University of Campinas, Rua Monteiro Lobato, 80, Cidade Universitária Zeferino Vaz, 13083-862 Campinas, SP, Brazil. Electronic address:
Orange juice is widely consumed worldwide due to its sensory and nutritional characteristics. This beverage is susceptible to contamination by acidic-tolerant microorganisms due to its low pH, especially filamentous fungi and yeasts. To minimize fungal spoilage, companies usually submit juice to thermal treatments; sanitizers are also applied on surfaces to maintain the microbiological quality.
View Article and Find Full Text PDFRapid and precise treatment selection for antimicrobial-resistant infection enabled by a nano-dilution SlipChip.
Biosens Bioelectron
December 2024
School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200030, China; Zhengzhou Industrial Technology Research Institute of Shanghai Jiao Tong University, Zhengzhou, 450016, China. Electronic address:
Antimicrobial resistance (AMR) has become an increasingly severe threat to global health, and AMR-associated infection is one of the leading causes of death around the world. Due to the long turnaround time and the limited flexibility and availability of current antimicrobial susceptibility testing (AST) methods, a large portion of patients with bacterial infections are still treated empirically, increasing the risk of mistreatment. To address the demand for precision treatment of bacterial infections, we developed a nano-dilution SlipChip (nd-SlipChip)-based systematic evaluation method, which facilitates rapid, logic feedback for the assessment of antibiotics, antibiotic combinations, and phage therapy.
View Article and Find Full Text PDFAim: To study the adverse reactions that develop as a result of complex antibiotic therapy in patients with non-tuberculous lung mycobacterial (NTML) and to determine methods for their elimination without compromising the effectiveness of NTML treatment.
Materials And Methods: Examined 147 patients with confirmed NTML, for which they received treatment in accordance with the results of drug susceptibility of the pathogen. Before and during treatment, a study of clinical, biochemical blood tests, urinalysis, electrocardiogram, external respiration function, ultrasound of the abdominal organs and kidneys was performed.
Want 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!