The Rapid Drug Susceptibility Testing of Mycobacterium tuberculosis by GenoType$^{(R)}$ MTBDRplus in Contaminated Specimen

  • Heo, Reun (Department of Laboratory Medicine, Korean National Tuberculosis Association) ;
  • Kim, Yoon-Sik (Department of Biomedical Laboratory Science, Dongkang College)
  • Received : 2013.12.10
  • Accepted : 2013.12.26
  • Published : 2013.12.31

Abstract

There are several methods currently being used to diagnose tuberculosis in patients, such as smear, PCR, tuberculosis culture and X-ray. For a proper medical treatment, antimicrobial susceptibility test and rapid drug susceptibility testing have been operated. Tuberculosis bacilli usually need 3~8 weeks of culture period because of delay in RNA synthesis and require 15~22 hours for generation. After a germ raises in culture, we initiated antimicrobial susceptibility test for a proper treatment. It has some difficulties to give a proper prescription for a tuberculosis patient because antimicrobial susceptibility test requires 4 weeks. To supplement this, we are practicing drug susceptibility testing which allow us to know the sensibility of RMP and INH after 2 or 3 days. But this is only possible when more than 2 positive germ. Therefore, we should practice rapid drug susceptibility testing with culture test. But if media is contaminated by other germs except Mycobacterium tuberculosis, it's hard to interpret result about culture test and to practice antimicrobial susceptibility test and rapid drug susceptibility testing. Because we have to practice again smear, culture test after extracting specimen from the patient, time is consumed and proper patient treatment is postponed. To address these problems and quick patient treatment, rapid drug susceptibility testing is practiced by using GenoType$^{(R)}$ MTDRplus method. As a result of this method we detected sensibility 10 and 7 cases and resistance 0 and 3 cases using RIM and INH respectively with other 1 case toward medicals out of the total 11 test. In conclusion rapid drug susceptibility testing can be used from the contaminated specimen after elimination of contaminated source from culture and proved that it can be practiced for rapid examination of a tuberculosis patient.

Keywords

References

  1. Arnvig KB, Young DB. Identification of small RNAs in Mycobacterium tuberculosis. Mol Microbiol. 2009. 73: 397-408. https://doi.org/10.1111/j.1365-2958.2009.06777.x
  2. Arruda S, Bomfim G, Knights R, Huima-Byron T, Riley LW. Cloning of an Mycobacterium tuberculosis DNA fragment associated with entry and survival inside cells. Science. 1993. 261: 1454-1457. https://doi.org/10.1126/science.8367727
  3. Bai GH, Park YK, Choi YW, Bai JI, Kim HJ, Chang CL, Lee JK, Kim SJ. Trend of anti-tuberculosis drug resistance in Korea, 1994-2004. Int J Tuberc Lung Dis. 2007. 11: 571-576.
  4. Barksdale L, Kim KS. Mycobacterium. Bacteriol Rev. 1977. 41:217-372.
  5. Blair EB, Brown GL, Tull AH. Computer files and analyses of laboratory data from tuberculosis patients. II. Analyses of six years' data on sputum specimens. Am Rev Respir Dis. 1976. 113: 427-432.
  6. Cole ST, Brosch R, Parkhill J, Garnier T, Churcher C, Harris D, Gordon SV, Eiglmeier K, Gas S, Barry CE 3rd, Tekaia F, Badcock K, Basham D, Brown D, Chillingworth T, Connor R, Davies R, Devlin K, Feltwell T, Gentles S, Hamlin N, Holroyd S, Hornsby T, Jagels K, Krogh A, McLean J, Moule S, Murphy L, Oliver K, Osborne J, Quail MA, Rajandream MA, Rogers J, Rutter S, Seeger K, Skelton J, Squares R, Squares S, Sulston JE, Taylor K, Whitehead S, Barrell BG. Deciphering the biology of Mycobacterium tuberculosis from the complete genome sequence. Nature. 1998. 393: 537-544. https://doi.org/10.1038/31159
  7. Collins CH, Grange JM, Noble WC, Yates MD. Mycobacterium marinum infections in man. J Hyg (Lond). 1985. 94: 135-149. https://doi.org/10.1017/S0022172400061349
  8. Grange JM. Lupus and lepros. Int J Lepr Other Mycobact Dis. 1988. 56: 111-112.
  9. Grange JM. The mystery of the mycobacterial 'persistor'. Tuber Lung Dis. 1992. 73: 249-251. https://doi.org/10.1016/0962-8479(92)90128-7
  10. Groothuis DG, Yates MD (ED). Diagnostic and public health mycobacteriology, 2nd ed. Bureau of hygiene and tropical diseases. London. 1991.
  11. Imperiale BR, Zumarraga MJ, Weltman G, Zudiker R, Cataldi AA, Morcillo NS. First evaluation in Argentina of the $GenoType^{(s)}$ MTBDRplus assay for multidrug-resistant Mycobacterium tuberculosis detection from clinical isolates and specimens. Rev Argent Microbiol. 2012. 44: 283-289.
  12. Jeon DS, Shin DO, Kang HS, Sung NM, Kweon KS, Shin E, Kim KS, Lee MH, Park SK. Trend of Multidrug and Extensively Drug Resistant Tuberculosis in a Tuberculosis Referral Hospital, 2001-2005. Tuberc Respir Dis. 2008. 64: 187-193. https://doi.org/10.4046/trd.2008.64.3.187
  13. Jin BW, Hong YP, Kim SJ. A contace study to evaluate the BCG vaccination tuberculosis programme in Seoul Tubercle. 1989.70: 241.
  14. Kent PT, Kubica GP. Public Health Mycobaceriology. a Guide for the Level III Laboratory. Atlanta, Georgia, USA: DHHS, CDC. 1985. 35.
  15. Kim EJ, Choi WS, Hwang SY. Detection of Mycobacterim tuberculosis by PCR from trace clinical specimens and paraffin-embedded tissue. Korean J Biomed Lab Sci. 2000.6: 56-63.
  16. Kim SJ, Bai GH, Hwang HD. Tubercle Bacilli in the Sputum Specimens. Tuberc Respir Dis. 1989. 36: 354-361.
  17. Lei Z, Yuanxing Y, Lina D, Tingting W, Xingbo S, Xiaojun L, Binwu Y, Lanlan W. Application of Genotype MTBDRplus in rapid detection of the Mycobacterium tuberculosis complex as well as its resistance to isoniazid and rifampin in a high volum laboratory in Southern China. Mol Biol Rep. 2010. 38: 2185-2192.
  18. Mullis KB, Faloona FA. Specific synthesis of DNA in vitro via a polymerase-catalyzed chain reaction. Methods Enzymol. 1987. 155: 335-350. https://doi.org/10.1016/0076-6879(87)55023-6
  19. Padungchan S, Konjanart S, Kasiratta S, Datamas S, ten Dam HG. The effectiveness of BCG Vaccination of the Konjanation of the newborn against childhood tuberculosis in Bangkok. Bull WHO. 1986. 64: 247.
  20. Padungchan S, Konjanart S, Kasiratta S, Daramas S, ten Dam HG. vaccination programme in Seoul. Tubercle. 1987. 70: 241.
  21. Pietrzak J, Frei R, Senn HP, Moroni C. Comparison of polymerase chain reaction with standard methods in the diagnosis of Mycobacterium tuberculosis infection. Eur J Clin Microbiol Infect Dis. 1994. 13: 1079-1083. https://doi.org/10.1007/BF02111834
  22. Saiki RK, Scharf S, Faloona F, Mullis KB, Horn GT, Erlich HA, Arnheim N. Enzymatic amplification of beta-globin genomic sequences and restriction site analysis for diagnosis of sickle cell anemia. 1985. Biotechnology. 1992. 24: 476-480.
  23. Saiki RK, Gelfand DH, Stoffel S, Scharf SJ, Higuchi R, Horn GT, Mullis KB, Erlich HA. Primer-directed enzymatic amplification of DNA with a thermostable DNA polymerase. Science. 1988. 239: 487-491. https://doi.org/10.1126/science.2448875
  24. Toman K. How can progress of treatment result be assessed?. In Tuberculosis. Geneva. WHO. 1979. 179.
  25. Vijdea R, Stegger M, Sosnovskaja A, Andersen ${\AA}B$, Thomsen $V\phi$, Bang D. Multidrug-resistant tuberculosis: rapid detection of resistance to rifampin and high or low levels of isoniazid in clinical specimens and isolates. Eur J Clin Microbiol Infect Dis. 2008. 27: 1079-1086. https://doi.org/10.1007/s10096-008-0548-9