Source: Annual Congress 2010 - Multidrug-resistant and extensively drug-resistant tuberculosis
Disease area: Respiratory infections

Abstract

Under growing multi-drug resistant (MDR) TB incidence, we observe escalation of so-called extensively drug resistant TB (XDR TB), i.e. MDR resistance plus resistance to a fluoroquinolone (FQ) and an aminoglycoside (AMG). Prevalence of MDR and XDR strains testifies to emergence of a new dangerous source of TB infection resistant to major TB drugs.
For the most rapid detection of such dangerous strains in TB patients, we developed an algorithm to diagnose M. tuberculosis resistance to TB drugs. Along with rapid bacteriology drug resistance determination using the automated system Bactec MGIT 960 (Becton Dickinson) we used two molecular genetic certified test-systems: TB-Biochip and TB-Biochip-2 (Biochip-IMB, Russia). To determine resistance to AMG we developed our own test-system based on the restriction analysis of M. tuberculosis rrs gene, which mutation determined resistance to these drugs.
We studied sputum and cultures of M. tuberculosis collected in 301 patients admitted to our center.
Our study resulted in detection of 11.2% MDR cases among new TB patients, out of which 3.4% were already resistant to FQ. We also detected 84.8% MDR cases among chronic TB patients, out of which 56.5% were resistant to FQ before treatment. In the latter group XDR TB was detected in 6 patients.
Thus, inclusion of biological microchips in laboratory studies of diagnostic samples collected in TB patients allowed rapid (within 48 hours) and effective (91.9% detection and drug resistance determination rate) obtaining reliable data on M. tuberculosis resistance to isoniazid, rifampicin and FQ. The restriction analysis demonstrated high concordance with the results obtained using solid Lowenstein-Jensen medium.

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Citations should be made in the following way:
E. Nosova, A. Bukatina, K. Galkina, M. Krasnova (Moscow, Russian Federation). Diagnosis of Mycobacterium tuberculosis drug resistance using molecular genetic methods. Eur Respir J 2010; 36: Suppl. 54, 354

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