Original Research

Resazurin microtitre plate assay and Sensititre® MycoTB for detection of Mycobacterium tuberculosis resistance in a high tuberculosis resistance setting

Prenika Jaglal, Melendhran Pillay, Koleka Mlisana
African Journal of Laboratory Medicine | Vol 8, No 1 | a840 | DOI: https://doi.org/10.4102/ajlm.v8i1.840 | © 2019 Prenika Jaglal, Melendhran Pillay, Koleka Mlisana | This work is licensed under CC Attribution 4.0
Submitted: 30 May 2018 | Published: 13 December 2019

About the author(s)

Prenika Jaglal, Department of Medical Microbiology, National Health Laboratory Services, School of Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Durban, South Africa
Melendhran Pillay, Department of Medical Microbiology/Virology, National Health Laboratory Service, Durban, South Africa
Koleka Mlisana, Department of Medical Microbiology, National Health Laboratory Services, School of Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Durban, South Africa


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Abstract

Background: Rapid diagnosis of drug-resistant Mycobacterium tuberculosis is a challenge in low-income countries. Phenotypic drug susceptibility testing using Sensititre® MycoTB assay and the resazurin microtitre plate assay (REMA) are relatively new innovative methods to determine drug susceptibility.

Objectives: This study aimed to determine the performance of the Sensititre and REMA for M. tuberculosis drug susceptibility testing in a high-volume tuberculosis reference laboratory.

Methods: A laboratory-based study was performed at the Inkosi Albert Luthuli Central Hospital Tuberculosis Laboratory from January 2014 to June 2015. The Sensititre® MycoTB plate and REMA were compared to the gold standard agar proportion method (APM) using 134 stored isolates.

Results: Agreement between the Sensititre® MycoTB plate and APM was observed with 98% sensitivity, 82% specificity, 94% positive and 93% negative predictive values of the Sensititre® MycoTB assay for the detection of rifampicin resistance and 97%, 96%, 99% and 88% for isoniazid resistance. Good categorical agreement between the REMA and the APM was observed among isolates with 89% sensitivity, 68% specificity, 89% positive and 68% negative predictive value for the detection of rifampicin resistance and 95%, 96%, 99% and 81% for isoniazid resistance. Results for the second-line drugs showed elevated minimum inhibitory concentrations for multidrug-resistant and extensively drug-resistant tuberculosis isolates.

Conclusion: The REMA and Sensititre® MycoTB plate are attractive alternatives to the gold standard APM for the phenotypic detection of M. tuberculosis drug resistance.


Keywords

Mycobacterium tuberculosis; agar proportion method; multidrug-resistant tuberculosis; extensively drug-resistant tuberculosis; Sensititre® MycoTB assay; resazurin microtitre plate assay

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