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MYCOBACTERİUM TUBERCULOSİS KOMPLEKSİ KLİNİK İZOLATLARINDA İZONİAZİD VE RİFAMPİSİN DİRENCİNİN HIZLI TANISI İÇİN ‘REVERSE BLOT HYBRIDIZATION ASSAY MYCOBACTERIUM TUBERCULOSIS DRUG RESISTANCE’ YÖNTEMİNİN ETKİNLİĞİNİN ARAŞTIRILMASI

Year 2019, Volume: 26 Issue: 4, 444 - 451, 01.12.2019
https://doi.org/10.17343/sdutfd.534941

Abstract

Amaç: Dirençli Mycobacterium
tuberculosis
kompleksi klinik izolatlarının hızlı tespiti, erken ve uygun
tedavinin planlanmasında en önemli basamaktır. REBA MTB-MDR, klinik izolatlarda
rpoB, katG, inhA, ahpC gen
mutasyonlarının hızlı tespiti için tasarlanan ve ticari olarak temin edilen
reverse blot hibridizasyon esaslı bir DNA strip testidir. Bu çalışmanın amacı M. tuberculosis kompleksi klinik
izolatlarında izoniazid (INH) ve rifampisin (RIF) direnci ile ilişkili mutasyon
tiplerinin REBA MTB-MDR testi ile belirlenmesi ve testin tanısal performansının
BACTEC MGIT 960 ile karşılaştırılmasıdır.



Gereç ve Yöntem:
Çalışma, 2008-2013 yılları arasında Süleyman Demirel Üniversitesi Tıp Fakültesi
Mikrobiyoloji laboratuvarında çeşitli klinik örneklerden izole edilen 55 M.
tuberculosis

kompleks
suşu ile yapıldı. Suşların primer anti tüberküloz ilaç duyarlılıkları  BACTEC MGIT 960 sistemiyle belirlendikten
sonra INH ve RIF direnci gen mutasyonları REBA MTB-MDR testi ile araştırıldı.



Bulgular: Çalışılan 55 izolatın MGIT 960 sistemiyle 41’i (%74.5)
primer anti tüberküloz ilaçlara duyarlı, 14’ü dirençli (%25.5) bulundu. REBA
MTB-MDR, MGIT 960 ile karşılaştırılarak değerlendirildiğinde RIF direncini
saptamada duyarlılık %25 (CI 4.12-79.6), özgüllük %100, PPD %100, NPD % 93.7
olarak, INH direncini saptamada ise duyarlılık %22.2 (CI 3.47-59.9), özgüllük
%97.5, PPD %66.6, NPD %84.7 olarak belirlendi.



Sonuç: Literatürle birlikte
değerlendirildiğinde REBA MTB-MDR testinin, dirençli M. tuberculosis kompleksi klinik izolatlarında en yaygın görülen
mutasyonların hızlı tespitinde ve uygun tedaviye başlamada hız kazandırması
açısından değerli olduğu görülmüştür. Ancak bu testin sık görülmeyen
mutasyonları belirlemedeki kısıtlılığı ve ilaç direncinde başka mekanizmaların
varlığı nedeni ile rutin klinik laboratuvarlarda tek başına değil, geleneksel
duyarlılık testleri ile birlikte kullanılmasının daha doğru olacağı kanaatine
varılmıştır.

References

  • 1. Türkiye’de Verem Savaşı 2017 Raporu [Internet]. Ankara; 2017. Available from: https://www.saglik.gov.tr
  • 2. CLSI. Laboratory Detection and Identification of Mycobacteria; Approved Guideline. Clinical and Laboratory Standards Institute; 2008.
  • 3. Jain A, Dixit P. Multidrug-resistant to extensively drug resistant tuberculosis: what is next? J Biosci. 2008 Nov;33(4): 605–16.
  • 4. National Committee for Clinical Laboratory Standards: Susceptibility Testing of Mycobacteria, Nocardiae, and Other Aerobic Actinomycetes; Approved Standard. Pennsylvania: NCCLS document M24-A; 2003.
  • 5. Durmaz R. Tüberkülozda Hızlı Moleküler Tanı Testleri. ANKEM Derg. 2012;26(2): 72–81.
  • 6. Center for Diseases Control. Report of Expert Consultations on Rapid Molecular Testing to Detect Drug-. Page last reviewed Resistant Tuberculosis in the United. http://www.cdc.gov/tb/topic/laboratory/ rapidmoleculartesting/default.htm: July 1, 2011.
  • 7. Bang H, Park S, Hwang J, Jin H, Cho E, Kim DY, et al. Improved rapid molecular diagnosis of multidrug-resistant tuberculosis using a new reverse hybridization assay, REBA MTB-MDR. J Med Microbiol. 2011 Oct;60: 1447–54.
  • 8. Cho E, Shamputa IC, Kwak H-K, Lee J, Lee M, Hwang S, et al. Utility of the REBA MTB-rifa(R) assay for rapid detection of rifampicin resistant Mycobacterium Tuberculosis. BMC Infect Dis. 2013 Oct;13: 478.
  • 9. MolecuTech REBA MTB-MDR, User’s Manuel. Korea: YD Diagnostics; 2012.
  • 10. Cruciani M, Scarparo C, Malena M, Bosco O, Serpelloni G, Mengoli C. Meta-Analysis of BACTEC MGIT 960 and BACTEC 460 TB, with or without Solid Media, for Detection of Mycobacteria. J Clin Microbiol. 2004 May;42(5): 2321–5.
  • 11. Adjers-Koskela K, Katila M-L. Susceptibility Testing with the Manual Mycobacteria Growth Indicator Tube (MGIT) and the MGIT 960 System Provides Rapid and Reliable Verification of Multidrug-Resistant Tuberculosis. J Clin Microbiol. 2003 Mar;41(3): 1235–9.
  • 12. Ramaswamy SV, Reich R, Dou S-J, Jasperse L, Pan X, Wanger A, et al. Single nucleotide polymorphisms in genes associated with isoniazid resistance in Mycobacterium tuberculosis. Antimicrob Agents Chemother. 2003 Apr;47(4): 1241–50.
  • 13. Brossier F, Veziris N, Truffot-Pernot C, Jarlier V, Sougakoff W. Performance of the genotype MTBDR line probe assay for detection of resistance to rifampin and isoniazid in strains of Mycobacterium tuberculosis with low- and high-level resistance. J Clin Microbiol. 2006 Oct;44(10): 3659–64.
  • 14. Hillemann D, Weizenegger M, Kubica T, Richter E, Niemann S. Use of the genotype MTBDR assay for rapid detection of rifampin and isoniazid resistance in Mycobacterium tuberculosis complex isolates. J Clin Microbiol. 2005 Aug;43(8): 3699–703.
  • 15. Cavusoglu C, Turhan A, Akinci P, Soyler I. Evaluation of the Genotype MTBDR assay for rapid detection of rifampin and isoniazid resistance in Mycobacterium tuberculosis isolates. J Clin Microbiol. 2006 Jul;44(7): 2338–42.
  • 16. Miotto P, Piana F, Penati V, Canducci F, Migliori GB, Cirillo DM. Use of genotype MTBDR assay for molecular detection of rifampin and isoniazid resistance in Mycobacterium tuberculosis clinical strains isolated in Italy. J Clin Microbiol. 2006 Jul;44(7): 2485–91.
  • 17. Aslan G, Tezcan S, Emekdaş G. Mycobacterium tuberculosis kompleksi klinik izolatlarında rifampisin ve izoniazid direncinin hızlı tespitinde “Genotype MTBDR” testinin değerlendirilmesi. Mikrobiyol Bul. 2009;43: 217–26.
  • 18. Hillemann D, Rüsch-Gerdes S, Richter E. Evaluation of the GenoType MTBDRplus assay for rifampin and isoniazid susceptibility testing of Mycobacterium tuberculosis strains and clinical specimens. J Clin Microbiol. 2007 Aug;45(8): 2635–40.
  • 19. Lacoma A, Garcia-Sierra N, Prat C, Ruiz-Manzano J, Haba L, Rosés S, et al. GenoType MTBDRplus assay for molecular detection of rifampin and isoniazid resistance in Mycobacterium tuberculosis strains and clinical samples. J Clin Microbiol. 2008 Nov;46(11): 3660–7.
  • 20. Keerataya Ngamlert, Efficiency of drug resistant Mycobacterium tuberculosis detection betweenXpert MTB/RIF and Lıne Probe Assay Using REBA MTB-MDR. J Med Tech Assoc Thailaland. 2016 April;44(1)
  • 21. Havumaki J, Hillemann D, et al. Comparative accuracy of the REBA MTB MDR and Hain MTBDRplus line probe assays for the detection of multidrug-resisstant tuberculosis: A multicenter,non inferiority study. PLoS One. 2017 March;12(3)
Year 2019, Volume: 26 Issue: 4, 444 - 451, 01.12.2019
https://doi.org/10.17343/sdutfd.534941

Abstract

References

  • 1. Türkiye’de Verem Savaşı 2017 Raporu [Internet]. Ankara; 2017. Available from: https://www.saglik.gov.tr
  • 2. CLSI. Laboratory Detection and Identification of Mycobacteria; Approved Guideline. Clinical and Laboratory Standards Institute; 2008.
  • 3. Jain A, Dixit P. Multidrug-resistant to extensively drug resistant tuberculosis: what is next? J Biosci. 2008 Nov;33(4): 605–16.
  • 4. National Committee for Clinical Laboratory Standards: Susceptibility Testing of Mycobacteria, Nocardiae, and Other Aerobic Actinomycetes; Approved Standard. Pennsylvania: NCCLS document M24-A; 2003.
  • 5. Durmaz R. Tüberkülozda Hızlı Moleküler Tanı Testleri. ANKEM Derg. 2012;26(2): 72–81.
  • 6. Center for Diseases Control. Report of Expert Consultations on Rapid Molecular Testing to Detect Drug-. Page last reviewed Resistant Tuberculosis in the United. http://www.cdc.gov/tb/topic/laboratory/ rapidmoleculartesting/default.htm: July 1, 2011.
  • 7. Bang H, Park S, Hwang J, Jin H, Cho E, Kim DY, et al. Improved rapid molecular diagnosis of multidrug-resistant tuberculosis using a new reverse hybridization assay, REBA MTB-MDR. J Med Microbiol. 2011 Oct;60: 1447–54.
  • 8. Cho E, Shamputa IC, Kwak H-K, Lee J, Lee M, Hwang S, et al. Utility of the REBA MTB-rifa(R) assay for rapid detection of rifampicin resistant Mycobacterium Tuberculosis. BMC Infect Dis. 2013 Oct;13: 478.
  • 9. MolecuTech REBA MTB-MDR, User’s Manuel. Korea: YD Diagnostics; 2012.
  • 10. Cruciani M, Scarparo C, Malena M, Bosco O, Serpelloni G, Mengoli C. Meta-Analysis of BACTEC MGIT 960 and BACTEC 460 TB, with or without Solid Media, for Detection of Mycobacteria. J Clin Microbiol. 2004 May;42(5): 2321–5.
  • 11. Adjers-Koskela K, Katila M-L. Susceptibility Testing with the Manual Mycobacteria Growth Indicator Tube (MGIT) and the MGIT 960 System Provides Rapid and Reliable Verification of Multidrug-Resistant Tuberculosis. J Clin Microbiol. 2003 Mar;41(3): 1235–9.
  • 12. Ramaswamy SV, Reich R, Dou S-J, Jasperse L, Pan X, Wanger A, et al. Single nucleotide polymorphisms in genes associated with isoniazid resistance in Mycobacterium tuberculosis. Antimicrob Agents Chemother. 2003 Apr;47(4): 1241–50.
  • 13. Brossier F, Veziris N, Truffot-Pernot C, Jarlier V, Sougakoff W. Performance of the genotype MTBDR line probe assay for detection of resistance to rifampin and isoniazid in strains of Mycobacterium tuberculosis with low- and high-level resistance. J Clin Microbiol. 2006 Oct;44(10): 3659–64.
  • 14. Hillemann D, Weizenegger M, Kubica T, Richter E, Niemann S. Use of the genotype MTBDR assay for rapid detection of rifampin and isoniazid resistance in Mycobacterium tuberculosis complex isolates. J Clin Microbiol. 2005 Aug;43(8): 3699–703.
  • 15. Cavusoglu C, Turhan A, Akinci P, Soyler I. Evaluation of the Genotype MTBDR assay for rapid detection of rifampin and isoniazid resistance in Mycobacterium tuberculosis isolates. J Clin Microbiol. 2006 Jul;44(7): 2338–42.
  • 16. Miotto P, Piana F, Penati V, Canducci F, Migliori GB, Cirillo DM. Use of genotype MTBDR assay for molecular detection of rifampin and isoniazid resistance in Mycobacterium tuberculosis clinical strains isolated in Italy. J Clin Microbiol. 2006 Jul;44(7): 2485–91.
  • 17. Aslan G, Tezcan S, Emekdaş G. Mycobacterium tuberculosis kompleksi klinik izolatlarında rifampisin ve izoniazid direncinin hızlı tespitinde “Genotype MTBDR” testinin değerlendirilmesi. Mikrobiyol Bul. 2009;43: 217–26.
  • 18. Hillemann D, Rüsch-Gerdes S, Richter E. Evaluation of the GenoType MTBDRplus assay for rifampin and isoniazid susceptibility testing of Mycobacterium tuberculosis strains and clinical specimens. J Clin Microbiol. 2007 Aug;45(8): 2635–40.
  • 19. Lacoma A, Garcia-Sierra N, Prat C, Ruiz-Manzano J, Haba L, Rosés S, et al. GenoType MTBDRplus assay for molecular detection of rifampin and isoniazid resistance in Mycobacterium tuberculosis strains and clinical samples. J Clin Microbiol. 2008 Nov;46(11): 3660–7.
  • 20. Keerataya Ngamlert, Efficiency of drug resistant Mycobacterium tuberculosis detection betweenXpert MTB/RIF and Lıne Probe Assay Using REBA MTB-MDR. J Med Tech Assoc Thailaland. 2016 April;44(1)
  • 21. Havumaki J, Hillemann D, et al. Comparative accuracy of the REBA MTB MDR and Hain MTBDRplus line probe assays for the detection of multidrug-resisstant tuberculosis: A multicenter,non inferiority study. PLoS One. 2017 March;12(3)
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Tuba Öztürk

Buket Arıdoğan

Emel Sesli Çetin

Publication Date December 1, 2019
Submission Date March 3, 2019
Acceptance Date May 6, 2019
Published in Issue Year 2019 Volume: 26 Issue: 4

Cite

Vancouver Öztürk T, Arıdoğan B, Sesli Çetin E. MYCOBACTERİUM TUBERCULOSİS KOMPLEKSİ KLİNİK İZOLATLARINDA İZONİAZİD VE RİFAMPİSİN DİRENCİNİN HIZLI TANISI İÇİN ‘REVERSE BLOT HYBRIDIZATION ASSAY MYCOBACTERIUM TUBERCULOSIS DRUG RESISTANCE’ YÖNTEMİNİN ETKİNLİĞİNİN ARAŞTIRILMASI. Med J SDU. 2019;26(4):444-51.

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