背景:在全球范围内,印度拥有由结核分枝杆菌(MTB)复合体引起的结核病(TB)病例数量最多的区别。这项研究旨在评估敏感性,特异性,准确度,成本,快速性,以及以Lowenstein-Jensen培养基为金标准的基于比色硝酸还原酶的抗生素敏感性(CONRAS)测试与间接比例法(IPM)的性能的可行性。
方法:对51株MTB分离株进行了比较横断面研究。新鲜的传代培养物用于在Lowenstein-Jensen培养基上通过IPM进行药物敏感性测试,在液体培养基中通过CONRAS方法进行药物敏感性测试。使用已知的MTB敏感菌株(H37Rv)和对异烟肼(INH)和利福平(RIF)均耐药的菌株进行药物敏感性测试的质量控制-多药耐药(MDR),单抗RIF,链霉素(STM),和乙胺丁醇(EMB)。使用MedCalc软件(版本20.027)进行统计学分析。
结果:结果,在微量离心管中进行,具有成本效益且易于执行/解释,与IPM的42天相比,大多数结果在10天内可用。敏感性,特异性,RIF和INH的准确度为100%,97.37%,98.04和93.33%,97.59%,和96.08%,分别,这转化为两种方法之间几乎完美的一致性,分别由κ值0.905和0.949表示,这两种药物。当与IPM相比时,CONRAS的性能对于STM和EMB不太令人满意。
结论:CONRAS由于其准确性,可以作为检测耐多药结核病的有用测试,低成本,易于性能/解释,与LJ培养基上的IPM相比,速度和速度。它不涉及使用昂贵的试剂和设备,就像GeneXpert和线探针测定等分子方法一样,使其成为在资源匮乏的环境中检测耐多药结核病的合适选择。
BACKGROUND: On a global scale, India holds the distinction of having the greatest number of tuberculosis (TB) cases caused by Mycobacterium tuberculosis (MTB) complex. The study aimed at evaluating the sensitivity, specificity, accuracy, cost, rapidity, and feasibility of the performance of the colorimetric nitrate reductase-based antibiotic susceptibility (CONRAS) test against the indirect proportion method (IPM) on Lowenstein-Jensen media as the gold standard.
METHODS: A comparative cross-sectional study was performed on 51 MTB isolates. Fresh subcultures were used for drug susceptibility testing by IPM on the Lowenstein-Jensen medium and the CONRAS method in liquid medium. Quality control for drug susceptibility testing was done using a known sensitive strain of MTB (H37Rv) and strains resistant to both isoniazid (INH) and rifampicin (RIF) - multidrug-resistant (MDR), mono-resistant to RIF, streptomycin (STM), and ethambutol (EMB). Statistical analysis was performed using MedCalc software (Version 20.027).
RESULTS: CONRAS, carried out in microfuge tubes, was cost-efficient and easy to perform/interpret with most results being available in 10 days compared to 42 days in the case of IPM. The sensitivity, specificity, and accuracy of RIF and INH were 100%, 97.37%, and 98.04 and 93.33%, 97.59%, and 96.08%, respectively, which translates into an almost perfect agreement between the two methods as indicated by κ value of 0.905 and 0.949, respectively, for the two drugs. The performance of CONRAS was less satisfactory for STM and EMB when compared to IPM.
CONCLUSIONS: CONRAS may serve as a useful test for the detection of MDR-TB because of its accuracy, low cost, ease of performance/interpretation, and rapidity when compared to IPM on LJ medium. It does not involve the use of expensive reagents and equipment, as is the case with molecular methods like GeneXpert and line probe assay, making it a suitable option for the detection of MDR-TB in resource-poor settings.