Multidrug-resistant tuberculosis: Rapid molecular detection with MTBDRplus® assay in clinical samples
Tuberculose multirresistente: Detecção directa em amostras respiratórias com o método de genética molecular MTBDRplus®
Rita Macedo1,
, António Amorim1, Edna Pereira1
Corresponding author
rita.macedo@csalcantara.min-saude.pt
Correspondence to/Correspondência: Laboratório de Saúde Pública – Micobacteriologia/ Tuberculose, Administração Regional de Saúde de Lisboa e Vale do Tejo, I.P., Rua Pedro Cálmon, n.° 25, 1300-455 Lisboa, Tel.: +351 213602520, Fax: +351 213602525.
Correspondence to/Correspondência: Laboratório de Saúde Pública – Micobacteriologia/ Tuberculose, Administração Regional de Saúde de Lisboa e Vale do Tejo, I.P., Rua Pedro Cálmon, n.° 25, 1300-455 Lisboa, Tel.: +351 213602520, Fax: +351 213602525.
1 Laboratório de Saúde Pública: Micobacteriologia/ Tuberculose, Administração Regional de Saúde de Lisboa e Vale do Tejo, IP/Public Health Laboratory: Mycobacteriology/Tuberculosis, Regional Health Administration, Lisbon and Tagus Valley Health Authority
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Rapid determination of drug resistance in clinical samples, with <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> complex (MTC), is the prerequisite for initiating effective chemotherapy, ensuring successful treatment of the patient and preventing further spread of drugresistant isolates.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The aim of our study was to determine the sensitivity of the new MTBDRplus<span class="elsevierStyleSup">®</span> assay in comparison to culture, identification and classic DST, directly from smear-positive clinical specimens.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 68 smear-positive sputum specimens were processed by both the classical mycobacteriological methods and the molecular assay, MTBDRplus<span class="elsevierStyleSup">®</span>.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">MTBDRplus<span class="elsevierStyleSup">®</span> assay allowed an accurate identification of MTC species by detection of the specific band in all samples, from which we also isolated and identified MTC strains by culture methods. In the samples from which we isolated susceptible strains (63.2%), wild type patterns were found using MTBDRplus<span class="elsevierStyleSup">®</span> assay. The samples from which we isolated resistant strains (36.8%) showed specific mutations associated with the correspondent resistant phenotype.</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Our study indicated that this assay allows rapid detection of resistance, always in agreement with classic methods.</p>" ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Uma das principais problematicas no controlo da tuberculose e o aparecimento de casos de tuberculose multirresistente (TB-MR) e tuberculose extensivamente resistente (TB-XDR). A deteccao precoce da resistencia a farmacos, directamente a partir de amostras respiratorias, e essencial para que se assegure o tratamento atempado, adequado e eficaz da tuberculose, bem como para prevenir a disseminacao destes casos de especial gravidade.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">O nosso objectivo foi avaliar a sensibilidade e comparar os resultados obtidos com um metodo de genetica molecular disponivel comercialmente – MTBDRplus<span class="elsevierStyleBold">®</span> – e o isolamento, identificacao e testes de sensibilidade classicos, directamente a partir de amostras respiratorias. Estudamos 68 amostras, com baciloscopia positiva.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">O MTBDRplus<span class="elsevierStyleBold">®</span> permitiu identificar, directamente a partir das amostras respiratorias, o complexo <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> em todos os casos em que o estudo cultural e a identificacao classica chegaram a esse mesmo resultado. Nas amostras em que culturalmente isolamos estirpes sensiveis, com o MTBDRplus<span class="elsevierStyleBold">®</span> encontramos sempre perfis geneticos do tipo selvagem (63,2%). Relativamente as amostras em que culturalmente isolamos estirpes resistentes, com o MTBDRplus<span class="elsevierStyleBold">®</span> encontramos sempre perfis geneticos com mutacoes ou com ausencia do perfil do tipo selvagem (36,8%).</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Este estudo permitiu concluir que o MTBDRplus<span class="elsevierStyleBold">®</span> assegura a deteccao rapida de resistencias a farmacos em estirpes do complexo <span class="elsevierStyleItalic">M. tuberculosis</span>, com resultados totalmente sobreponiveis aos obtidos com os metodos bacteriologicos classicos.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliography/Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| Year/Month | Html | Total | |
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