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Evaluation of the tuberculosis culture color plate test for rapid detection of drug susceptible and drug-resistant Mycobacterium tuberculosis in a resource-limited setting, Addis Ababa, Ethiopia

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Title: Evaluation of the tuberculosis culture color plate test for rapid detection of drug susceptible and drug-resistant Mycobacterium tuberculosis in a resource-limited setting, Addis Ababa, Ethiopia
Authors: Mekonnen, B
Mihret, A
Getahun, M
Hailu, T
Sidiki, S
V Kelley, H
Scordo, JM
Hunt, WG
Pan, X
Balada-Llasat, J-M
Gebreyes, W
Evans, CA
Aseffa, A
Torrelles, JB
Wang, S-H
Abebe, T
Item Type: Journal Article
Abstract: Timely diagnosis of tuberculosis (TB) is limited in Ethiopia. We evaluated the performance of a low technology, thin layer agar, Mycobacterium tuberculosis (M.tb) culture color plate (TB-CX) test with concurrent drug susceptibility testing (DST) to isoniazid (INH), rifampin (RIF), and pyrazinamide (PZA) directly from sputum specimens. Patients undergoing examination for TB and multidrug-resistant (MDR)-TB were enrolled in Addis Ababa, Ethiopia from March 2016 to February 2017. All subjects received a GeneXpert MTB/RIF PCR test. TB-CX test results were compared to reference Löwenstein-Jensen (LJ) culture for M.tb detection and DST for susceptibility to INH and RIF. Kappa statistic was applied to test agreement between results for TB-CX test and the reference methods, a cut-off Kappa value of 0.75 was considered as high level of agreements. A total of 137 participants were analyzed: 88 (64%) were new TB cases, 49 (36%) were re-treatment cases. The TB-CX test detected M.tb and DST in an average of 13 days compared to 50 days for the conventional DST result. The sensitivity and specificity of the TB-CX test for detecting M.tb were 94% and 98%, respectively (concordance, 96%; kappa 0.91). The sensitivity of the TB-CX test to detect drug resistance to INH, RIF, and MDR-TB was 91%, 100%, and 90% respectively. The specificity of the TB-CX test for detecting INH, RIF, and MDR-TB was 94%, 40%, and 94% respectively. Overall agreement between TB-CX test and LJ DST for detection of MDR-TB was 93%. The TB-CX test showed strong agreement with the GeneXpert test for detecting M.tb (89%, kappa 0.76) but low agreement for the detection of RIF resistance (57%, kappa 0.28). The TB-CX test was found to be a good alternative method for screening of TB and selective drug resistant-TB in a timely and cost-efficient manner.
Issue Date: 28-May-2019
Date of Acceptance: 7-Apr-2019
URI: http://hdl.handle.net/10044/1/70254
DOI: https://dx.doi.org/10.1371/journal.pone.0215679
ISSN: 1932-6203
Publisher: Public Library of Science (PLoS)
Journal / Book Title: PLoS ONE
Volume: 14
Issue: 5
Copyright Statement: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
Sponsor/Funder: Sir Halley Stewart Trust
Wellcome Trust
Wellcome Trust
Wellcome Trust
Medical Research Council (MRC)
Wellcome Trust
Wellcome Trust
Wellcome Trust
Funder's Grant Number: 103548/103356
070005/Z/02/Z
076340/Z/05/Z
076078/Z/04/Z
MR/K007467/1
097816/Z/11/A
105788/Z/14/Z
201251/Z/16/Z
Keywords: General Science & Technology
MD Multidisciplinary
Publication Status: Published
Conference Place: United States
Open Access location: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0215679&type=printable
Article Number: e0215679
Appears in Collections:Department of Medicine



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