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Castro-Rodriguez B, Franco-Sotomayor G, Rodriguez-Pazmiño ÁS, Cardenas-Franco GE, Orlando SA, Hermoso de Mendoza J, Parra-Vera H, García-Bereguiain MÁ. Rapid and accurate identification and differentiation of Mycobacterium tuberculosis and non-tuberculous mycobacteria using PCR kits available in a high-burden setting. Front Public Health 2024; 12:1358261. [PMID: 38628855 PMCID: PMC11018931 DOI: 10.3389/fpubh.2024.1358261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/04/2024] [Indexed: 04/19/2024] Open
Abstract
Infections caused by mycobacteria, including Mycobacterium tuberculosis complex (MTBC) and non-tuberculous mycobacteria (NTM), are a major public health issue worldwide. An accurate diagnosis of mycobacterial species is a challenge for surveillance and treatment, particularly in high-burden settings usually associated with low- and middle-income countries. In this study, we analyzed the clinical performance of two commercial PCR kits designed for the identification and differentiation of MTBC and NTM, available in a high-burden setting such as Ecuador. A total of 109 mycobacteria isolates were included in the study, 59 of which were previously characterized as M. tuberculosis and the other 59 as NTM. Both kits displayed great clinical performance for the identification of M. tuberculosis, with 100% sensitivity. On the other hand, for NTM, one of the kits displayed a good clinical performance with a sensitivity of 94.9% (CI 95%: 89-100%), while the second kit had a reduced sensitivity of 77.1% (CI 95%: 65-89%). In conclusion, one of the kits is a fast and reliable tool for the identification and discrimination of MTBC and NTM from clinical isolates.
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Affiliation(s)
| | - Greta Franco-Sotomayor
- Instituto Nacional de Investigación en Salud Pública "Leopoldo Izquieta Pérez", Guayaquil, Ecuador
- Universidad Católica Santiago de Guayaquil, Guayaquil, Ecuador
| | | | | | - Solón Alberto Orlando
- Instituto Nacional de Investigación en Salud Pública "Leopoldo Izquieta Pérez", Guayaquil, Ecuador
- Universidad Espíritu Santo, Samborondón, Ecuador
| | | | - Henry Parra-Vera
- Centro de Investigación Microbiológica (CIM), Guayaquil, Ecuador
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Chen CY, Weng JY, Huang HH, Yen WC, Tsai YH, Cheng TC, Jou R. A new oligonucleotide array for the detection of multidrug and extensively drug-resistance tuberculosis. Sci Rep 2019; 9:4425. [PMID: 30872613 PMCID: PMC6418274 DOI: 10.1038/s41598-019-39339-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/21/2019] [Indexed: 11/23/2022] Open
Abstract
Drug-resistant tuberculosis (TB) is a global crisis and a threat to health security. Since conventional drug susceptibility testing (DST) takes several weeks, we herein described a molecular assay to rapidly identify multidrug-resistant (MDR) and extensively drug-resistant (XDR) and reveal transmission associated-mutations of Mycobacterium tuberculosis complex (MTBC) isolates in 6 to 7 hours. An array was designed with 12 pairs of primers and 60 single nucleotide polymorphisms of 9 genes: rpoB, katG, inhA, ahpC, embB, rpsL, gyrA, rrs and eis. We assessed the performance of the array using 176 clinical MTBC isolates. The results of culture-based DST were used as the gold standard, the GenoType MTBDRplus and MTBDRsl tests were used for parallel comparison, and gene sequencing was performed to resolve the discordance. The sensitivities and specificities of the array are comparable to those of the MTBDRplus test for resistance to isoniazid (INH) (100.0%, 96.7%) and rifampicin (RIF) (99.4%, 96.7%) and of the MTBDRsl test for resistance to fluoroquinolones (FQs) (100%, 100%) and second-line injectable drugs (SLIDs) (98.3%, 100%). The sensitivities of the array for detecting resistance to ethambutol and streptomycin were 79.3% and 64.9%, respectively. The array has potential as a powerful tool for clinical diagnosis and epidemiological investigations.
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Affiliation(s)
- Ching-Yu Chen
- Tuberculosis Research Center, Centers for Disease Control, Ministry of Health and Welfare, Taipei, 115, Taiwan
| | - Jui-Yun Weng
- Tuberculosis Research Center, Centers for Disease Control, Ministry of Health and Welfare, Taipei, 115, Taiwan
| | - Hsin-Hui Huang
- Department of Medical Laboratory and Biotechnology, National Cheng Kung University, Tainan, 701, Taiwan
| | - Wen-Chun Yen
- Department of Medical Laboratory and Biotechnology, National Cheng Kung University, Tainan, 701, Taiwan
| | - Yu-Han Tsai
- Department of Medical Laboratory and Biotechnology, National Cheng Kung University, Tainan, 701, Taiwan
| | - Tsung Chain Cheng
- Department of Medical Laboratory and Biotechnology, National Cheng Kung University, Tainan, 701, Taiwan
| | - Ruwen Jou
- Tuberculosis Research Center, Centers for Disease Control, Ministry of Health and Welfare, Taipei, 115, Taiwan. .,Institute of Microbiology and Immunology, National Yang-Ming University, Taipei, 112, Taiwan.
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Lee S, Hwang KA, Ahn JH, Nam JH. Evaluation of EZplex MTBC/NTM Real-Time PCR kit: diagnostic accuracy and efficacy in vaccination. Clin Exp Vaccine Res 2018; 7:111-118. [PMID: 30112350 PMCID: PMC6082673 DOI: 10.7774/cevr.2018.7.2.111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 07/28/2018] [Accepted: 07/30/2018] [Indexed: 12/04/2022] Open
Abstract
Purpose Tuberculosis (TB) is mainly caused by Mycobacterium tuberculosis, which is a pathogenic mycobacterial species grouped under Mycobacterium tuberculosis complex (MTBC) with four other pathogenic mycobacterial species. The mycobacteria not included in MTBC are known as nontuberculous mycobacteria (NTM), and cause several pulmonary diseases including pneumonia. Currently, NTM occurrences in TB-suspected respiratory specimens have increased, due to which, precise detection of MTBC and NTM is considered critical for the diagnosis and vaccination of TB. Among the various methods available, real-time PCR is frequently adopted for MTBC/NTM detection due to its rapidness, accuracy, and ease of handling. In this study, we evaluated a new real-time PCR kit for analytical and clinical performance on sputum, bronchial washing, and culture specimens. Materials and Methods For assessing its analytical performance, limit of detection (LOD), reactivity, and repeatability test were performed using DNA samples. To evaluate clinical performance, 612 samples were collected and clinically tested at a tertiary hospital. Results LOD was confirmed as 0.584 copies/µL for MTBC and 47.836 copies/µL for NTM by probit analysis (95% positive). For the reactivity test, all intended strains were detected and, in the repeatability test, stable and steady results were confirmed with coefficient of variation ranging from 0.36 to 1.59. For the clinical test, sensitivity and specificity were 98.6%–100% and 98.8%–100% for MTBC and NTM, respectively. Conclusion The results proved the usefulness of the kit in TB diagnosis. Furthermore, it could be adopted for the assessment of vaccine efficacy.
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Affiliation(s)
- Suengmok Lee
- Department of Biotechnology, The Catholic University of Korea, Bucheon, Korea.,Department of Research and Development, Genetree Research, Seoul, Korea
| | - Kyung-A Hwang
- Department of Research and Development, Genetree Research, Seoul, Korea
| | - Ji-Hoon Ahn
- Department of Research and Development, Genetree Research, Seoul, Korea
| | - Jae-Hwan Nam
- Department of Biotechnology, The Catholic University of Korea, Bucheon, Korea
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Jeon J, Kim JK, Choi Q, Kim JW. Genetic and phenotypic characterizations of drug-resistant Mycobacterium tuberculosis isolates in Cheonan, Korea. J Clin Lab Anal 2018; 32:e22404. [PMID: 29396866 PMCID: PMC6817145 DOI: 10.1002/jcla.22404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 01/17/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Mycobacterium tuberculosis (MTB) causes tuberculosis (TB), which is a fatal disease. Cases of drug-resistant MTB have increased in recent years. In this study, we analyzed 7 sites of MTB DNA sequences, including the rpoB and inhA gene, to investigate the relationship between gene mutations and drug resistance in MTB. METHODS Mycobacterium tuberculosis liquid culture samples (197 specimens from 74 cases) were collected between June 2015 and May 2016 and sequenced. The results were compared with those obtained from antibiotic susceptibility tests. RESULTS In 65 (87.8%) cases, the antibiotic-resistant phenotype was consistent with genotyping results, whereas in 9 (12.2%) cases, there was no match. Eight mutations were detected in the rpoB gene, which showed the highest mutation rate. Sequencing results indicated that these mutations were present in 12 cases. CONCLUSION Previously published data on antibiotic resistance genes are insufficient for effective prevention of multidrug- or extensive drug-resistant TB. Additional studies are needed to characterize the complement of antibiotic resistance genes in MTB.
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Affiliation(s)
- Jae‐Sik Jeon
- Department of Biomedical Laboratory ScienceDankook University College of Health SciencesCheonanKorea
| | - Jae Kyung Kim
- Department of Biomedical Laboratory ScienceDankook University College of Health SciencesCheonanKorea
| | - Qute Choi
- Department of Laboratory MedicineDankook University HospitalCheonanKorea
| | - Jong Wan Kim
- Department of Laboratory MedicineDankook University College of MedicineCheonanKorea
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Sali M, De Maio F, Caccuri F, Campilongo F, Sanguinetti M, Fiorentini S, Delogu G, Giagulli C. Multicenter Evaluation of Anyplex Plus MTB/NTM MDR-TB Assay for Rapid Detection of Mycobacterium tuberculosis Complex and Multidrug-Resistant Isolates in Pulmonary and Extrapulmonary Specimens. J Clin Microbiol 2016; 54:59-63. [PMID: 26491178 PMCID: PMC4702753 DOI: 10.1128/jcm.01904-15] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/08/2015] [Indexed: 11/20/2022] Open
Abstract
The rapid diagnosis of tuberculosis (TB) and the detection of drug-resistant Mycobacterium tuberculosis strains are critical for successful public health interventions. Therefore, TB diagnosis requires the availability of diagnostic tools that allow the rapid detection of M. tuberculosis and drug resistance in clinical samples. Here, we performed a multicenter study to evaluate the performance of the Seegene Anyplex MTB/NTM MDR-TB assay, a new molecular method based on a multiplex real-time PCR system, for detection of Mycobacterium tuberculosis complex (MTBC), nontuberculous mycobacteria (NTM), and genetic determinants of drug resistance. In total, the results for 755 samples (534 pulmonary and 221 extrapulmonary samples) were compared with the results of smears and cultures. For pulmonary specimens, the sensitivities of the Anyplex assay and acid-fast bacillus smear testing were 86.4% and 75.0%, respectively, and the specificities were 99% and 99.4%. For extrapulmonary specimens, the sensitivities of the Anyplex assay and acid-fast bacillus smear testing were 83.3% and 50.0%, respectively, and the specificities of both were 100%. The negative and positive predictive values of the Anyplex assay for pulmonary specimens were 97% and 100%, respectively, and those for extrapulmonary specimens were 84.6% and 100%. The sensitivities of the Anyplex assay for detecting isoniazid resistance in MTBC strains from pulmonary and extrapulmonary specimens were 83.3% and 50%, respectively, while the specificities were 100% for both specimen types. These results demonstrate that the Anyplex MTB/NTM MDR-TB assay is an efficient and rapid method for the diagnosis of pulmonary and extrapulmonary TB and the detection of isoniazid resistance.
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Affiliation(s)
- Michela Sali
- Institute of Microbiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Flavio De Maio
- Institute of Microbiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Francesca Caccuri
- Section of Microbiology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Federica Campilongo
- Section of Microbiology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | | | - Simona Fiorentini
- Section of Microbiology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Giovanni Delogu
- Institute of Microbiology, Catholic University of the Sacred Heart, Rome, Italy
| | - Cinzia Giagulli
- Section of Microbiology, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
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Choe W, Kim E, Park SY, Chae JD. Performance Evaluation of Anyplex plus MTB/NTM and AdvanSure TB/NTM for the Detection of Mycobacterium tuberculosisand Nontuberculous Mycobacteria. ANNALS OF CLINICAL MICROBIOLOGY 2015. [DOI: 10.5145/acm.2015.18.2.44] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Wonho Choe
- Department of Laboratory Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Ehwa Kim
- Department of Laboratory Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Seo Yeon Park
- Department of Laboratory Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Jeong Don Chae
- Department of Laboratory Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
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