Evaluation of two line probe assays for rapid detection of mycobacterium tuberculosis, tuberculosis (TB) drug resistance, and non-TB mycobacteria in HIV-infected individuals with suspected TB

Anne F. Luetkemeyer, Michelle A. Kendall, Xingye Wu, Maria Cristina Lourenço, Ute Jentsch, Susan Swindells, Sarojini S. Qasba, Jorge Sanchez, Diane V. Havlir, Beatriz Grinsztejn, Ian M. Sanne, Cynthia Firnhaber

Research output: Contribution to journalArticle

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Abstract

Limited performance data from line probe assays (LPAs), nucleic acid tests used for the rapid diagnosis of tuberculosis (TB), nontuberculosis mycobacteria (NTM), and Mycobacterium tuberculosis drug resistance are available for HIV-infected individuals, in whom paucibacillary TB is common. In this study, the strategy of testing sputum with GenoType MTBDRplus (MTBDR-Plus) and GenoType Direct LPA (Direct LPA) was compared to a gold standard of one mycobacterial growth indicator tube (MGIT) liquid culture. HIV-positive (HIV+) individuals with suspected TB from southern Africa and South America with <7 days of TB treatment had 1 sputum specimen tested with Direct LPA, MTBDR-Plus LPA, smear microscopy, MGIT, biochemical identification of mycobacterial species, and culture-based drug-susceptibility testing (DST). Of 639 participants, 59.3% were MGIT M. tuberculosis culture positive, of which 276 (72.8%) were acid-fast bacillus (AFB) smear positive. MTBDR-Plus had a sensitivity of 81.0% and a specificity of 100%, with sensitivities of 44.1% in AFB smear-negative versus 94.6% in AFB smear-positive specimens. For specimens that were positive for M. tuberculosis by MTBDR-Plus, the sensitivity and specificity for rifampin resistance were 91.7% and 96.6%, respectively, and for isoniazid (INH) they were 70.6% and 99.1%. The Direct LPA had a sensitivity of 88.4% and a specificity of 94.6% for M. tuberculosis detection, with a sensitivity of 72.5% in smear-negative specimens. Ten of 639 MGIT cultures grew Mycobacterium avium complex or Mycobacterium kansasii, half of which were detected by Direct LPA. Both LPA assays performed well in specimens from HIV-infected individuals, including in AFB smear-negative specimens, with 72.5% sensitivity for M. tuberculosis identification with the Direct LPA and 44.1% sensitivity with MTBDR-Plus. LPAs have a continued role for use in settings where rapid identification of INH resistance and clinically relevant NTM are priorities.

Original languageEnglish (US)
Pages (from-to)1052-1059
Number of pages8
JournalJournal of clinical microbiology
Volume52
Issue number4
DOIs
StatePublished - Jan 1 2014

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Mycobacterium
Mycobacterium tuberculosis
Drug Resistance
Tuberculosis
HIV
Bacillus
Acids
Growth
Sputum
Mycobacterium kansasii
Genotype
Nucleic Acid Probes
Southern Africa
Mycobacterium avium Complex
South America
Isoniazid
Rifampin
Microscopy
Sensitivity and Specificity
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Microbiology (medical)

Cite this

Evaluation of two line probe assays for rapid detection of mycobacterium tuberculosis, tuberculosis (TB) drug resistance, and non-TB mycobacteria in HIV-infected individuals with suspected TB. / Luetkemeyer, Anne F.; Kendall, Michelle A.; Wu, Xingye; Lourenço, Maria Cristina; Jentsch, Ute; Swindells, Susan; Qasba, Sarojini S.; Sanchez, Jorge; Havlir, Diane V.; Grinsztejn, Beatriz; Sanne, Ian M.; Firnhaber, Cynthia.

In: Journal of clinical microbiology, Vol. 52, No. 4, 01.01.2014, p. 1052-1059.

Research output: Contribution to journalArticle

Luetkemeyer, AF, Kendall, MA, Wu, X, Lourenço, MC, Jentsch, U, Swindells, S, Qasba, SS, Sanchez, J, Havlir, DV, Grinsztejn, B, Sanne, IM & Firnhaber, C 2014, 'Evaluation of two line probe assays for rapid detection of mycobacterium tuberculosis, tuberculosis (TB) drug resistance, and non-TB mycobacteria in HIV-infected individuals with suspected TB', Journal of clinical microbiology, vol. 52, no. 4, pp. 1052-1059. https://doi.org/10.1128/JCM.02639-13
Luetkemeyer, Anne F. ; Kendall, Michelle A. ; Wu, Xingye ; Lourenço, Maria Cristina ; Jentsch, Ute ; Swindells, Susan ; Qasba, Sarojini S. ; Sanchez, Jorge ; Havlir, Diane V. ; Grinsztejn, Beatriz ; Sanne, Ian M. ; Firnhaber, Cynthia. / Evaluation of two line probe assays for rapid detection of mycobacterium tuberculosis, tuberculosis (TB) drug resistance, and non-TB mycobacteria in HIV-infected individuals with suspected TB. In: Journal of clinical microbiology. 2014 ; Vol. 52, No. 4. pp. 1052-1059.
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