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Comparison of rapid drug susceptibility tests for Mycobacterium tuberculosis clinical isolates

AuthorsAranzamendi Zaldumbide, M.; Martínez-Martínez, Luis
Issue DateApr-2010
CitationECCMID (2010)
Abstract[Objectives]: Drug resistant tuberculosis is a growing concern worldwide. Clinical microbiology laboratories should provide reliable results on susceptibility testing to assess effective treatment schemes and appropriate intervention measures to control the disease. In the present study, the efficiency of Etest and genotypic detection of isoniazid (INH) and rifampin (RAMP) resistance was evaluated by comparing results to those of the multiple proportion method as a reference. [Methods]: 100 Mycobacterium tuberculosis strains were selected from a stock collection of clinical isolates (January 2000- July 2009). CMI was determined by Etest in 50 strains known to be INH-R (n=42) or INH+RAMP (n=8) and in 50 susceptible strains. The genome regions associated with INH-R (including the codon 315 of the katG gene and the fabG1(mabA)-inhA regulatory region) and RAMP-R (81-bp hot spot region of the rpoB gene called RRDR) were amplified in all the strains by PCR and the DNA sequences were studied. [Results]: Very Mayor Error(VME) rates for INH susceptibility testing were 38% for Etest and 42% in genotypic detection with Category Agreement (CA) rates of 81% and 79%. In contrast, CA rates for Etest and genotypic detection were 99% and 100% respectively, for RAMP. Mayor Error(ME) rate for RAMP using Etest was 1.08%. Overall a significant number of isolates harbouring the mutation S315T in the katG and the total of multiresistant isolates showed high-level resistance (INH >256mg/L, RAMP >32mg/L). The results are summarized in Table 1. [Conclusions]: Our results demonstrated a low sensitivity of these methods to detect INH-R strains, and points to the need of finding out new phenotypic methods and other mutant regions. On the other side, confirm the feasibility of implementing both methods as fast and accurate alternatives for assessment of RAMP-R, which in turn is a marker for multiresistance.
DescriptionComunicación presentada al "20th European Congress of Clinical Microbiology and Infectious Diseases" celebrado en Viena (Austria) del 10 al 13 de abril de 2010.-- et al.
Publisher version (URL)http://www.congrex-switzerland.com/eccmid2010/
Appears in Collections:(IBBTEC) Comunicaciones congresos
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