1
|
Ejo M, Van Deun A, Nunn A, Meredith S, Ahmed S, Dalai D, Tumenbayar O, Tsogt B, Dat PT, Ha DTM, Hang PT, Kokebu D, Teferi M, Mebrahtu T, Ngubane N, Moodliar R, Duckworth L, Conradie F, Enduwamahoro E, Keysers J, De Rijk P, Mulders W, Diro E, Rigouts L, de Jong BC, Torrea G. Effectiveness of GenoType MTBDR sl in excluding TB drug resistance in a clinical trial. Int J Tuberc Lung Dis 2021; 25:839-845. [PMID: 34615581 DOI: 10.5588/ijtld.21.0212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES: To assess the performance of the GenoType MTBDRsl v1, a line-probe assay (LPA), to exclude baseline resistance to fluoroquinolones (FQs) and second-line injectables (SLIs) in the Standard Treatment Regimen of Anti-tuberculosis Drugs for Patients With MDR-TB 1 (STREAM 1) trial.METHODS: Direct sputum MTBDRsl results in the site laboratories were compared to indirect phenotypic drug susceptibility testing (pDST) results in the central laboratory, with DNA sequencing as a reference standard.RESULTS: Of 413 multidrug-resistant TB (MDR-TB) patients tested using MTBDRsl and pDST, 389 (94.2%) were FQ-susceptible and 7 (1.7%) FQ-resistant, while 17 (4.1%) had an inconclusive MTBDRsl result. For SLI, 372 (90.1%) were susceptible, 5 (1.2%) resistant and 36 (8.7%) inconclusive. There were 9 (2.3%) FQ discordant pDST/MTBDRsl results, of which 3 revealed a mutation and 5 (1.3%) SLI discordant pDST/MTBDRsl results, none of which were mutants on sequencing. Among the 17 FQ- and SLI MTBDRsl-inconclusive samples, sequencing showed 1 FQ- and zero SLI-resistant results, similar to frequencies among the conclusive MTBDRsl. The majority of inconclusive MTBDRsl results were associated with low bacillary load samples (acid-fast bacilli smear-negative or scantily positive) compared to conclusive results (P < 0.001).CONCLUSION: MTBDRsl can facilitate the rapid exclusion of FQ and SLI resistances for enrolment in clinical trials.
Collapse
Affiliation(s)
- M Ejo
- Institute of Tropical Medicine, Antwerp, Belgium, University of Gondar, Gondar, Ethiopia, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - A Van Deun
- Institute of Tropical Medicine, Antwerp, Belgium, Independent Consultant, Leuven, Belgium
| | - A Nunn
- Medical Research Council Clinical Trials at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - S Meredith
- Medical Research Council Clinical Trials at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - S Ahmed
- Medical Research Council Clinical Trials at UCL, Institute of Clinical Trials and Methodology, University College London, London, UK
| | - D Dalai
- National Centre of Infectious Diseases, National Tuberculosis Reference Laboratory, Ulaanbaatar, Mongolia
| | - O Tumenbayar
- National Centre of Infectious Diseases, National Tuberculosis Reference Laboratory, Ulaanbaatar, Mongolia
| | - B Tsogt
- Mongolian TB Coalition, Ulaanbaatar, Mongolia
| | - P T Dat
- Pham Ngoc Thach Hospital, Ho Chi Minh, Vietnam
| | - D T M Ha
- Pham Ngoc Thach Hospital, Ho Chi Minh, Vietnam
| | - P T Hang
- Pham Ngoc Thach Hospital, Ho Chi Minh, Vietnam
| | - D Kokebu
- Saint Peter´s TB Specialized Hospital, Addis Ababa, Ethiopia
| | - M Teferi
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - T Mebrahtu
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - N Ngubane
- Doris Goodwin Hospital, Pietermaritzburg, South Africa
| | - R Moodliar
- King Dinuzulu Hospital, Durban, South Africa
| | - L Duckworth
- King Dinuzulu Hospital, Durban, South Africa
| | - F Conradie
- Sizwe Tropical Disease, Johannesburg, South Africa
| | | | - J Keysers
- Institute of Tropical Medicine, Antwerp, Belgium
| | - P De Rijk
- Institute of Tropical Medicine, Antwerp, Belgium
| | - W Mulders
- Institute of Tropical Medicine, Antwerp, Belgium
| | - E Diro
- University of Gondar, Gondar, Ethiopia
| | - L Rigouts
- Institute of Tropical Medicine, Antwerp, Belgium, Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - B C de Jong
- Institute of Tropical Medicine, Antwerp, Belgium
| | - G Torrea
- Institute of Tropical Medicine, Antwerp, Belgium
| |
Collapse
|