Zaporožskij Medicinskij Žurnal (Apr 2017)

Use of the GenoType MTBDRplus for early diagnosis of multidrug-resistant tuberculosis

  • O. M. Raznatovska,
  • R. M. Yasinskyi,
  • O. V. Konakova,
  • Jean-Luc Berland,
  • Marie Gauhier

DOI
https://doi.org/10.14739/2310-1210.2017.2.95741
Journal volume & issue
no. 2
pp. 210 – 216

Abstract

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The type of diagnostics methods and their duration, loss of time for the appointment of the optimal treatment are the major categories of factors that influence on multidrug resistant tuberculosis treatment effectiveness. Problem of multidrug resistant tuberculosis and improving of its laboratory diagnosis is very important in Ukraine. Inadequate and ineffective treatment is applied in cases of delayed diagnostic of multidrug resistant tuberculosis in patient. It causes further spread of drug-resistant tuberculosis and increase of mycobacterium tuberculosis drug resistance to anti-tuberculosis drugs. Therefore, rapid diagnostics of multidrug resistant tuberculosis is a requirement for timely and correct treatment strategy, and one of the urgent problems of modern phthisiology. The aim of this review was to evaluate the GenoType MTBDRplus for early diagnosis of multidrug-resistant tuberculosis diagnostic in Ukraine. Conclusions. Use of the GenoType MTBDRplus (2.0) assay for rapid multidrug resistant tuberculosis detection in Ukraine is important. With Genotype MTBDRplus test TB Complex identification and resistance detection to INH and RMP is completed in 8 hours compared to 25 days in Bactec MGIT 960 System and three months on solid LG medium. Pulmonary specimens (sputum, bronchoalveolar lavage, bronchoscopic aspirate), as well as clinical specimens from extrapulmonary sites (pleural fluid, lymph node biopsy, ascitic fluid, cerebrospinal fluid) can be used. Smear-positive patients, as well smear-negative and pulmonary cases as well extra-pulmonary, would be to benefit from using the revised version 2.0 of MTBDRplus. The sensitivity of this method is 95 to 97 % and the specificity – up to 90.7 %. It is recommended for detection of MDR TB in contact persons, for screening of multi-resistant tuberculosis patients and for detection of multi-resistant tuberculosis in TB patients with treatment failure, for determination of genotype of Mycobacterium tuberculosis in the region. Qualified bacteriologic diagnostics has the potential to interrupt the transmission chain of resistant M. tuberculosis.

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