An Integrated Approach to Rapid Diagnosis of Tuberculosis and Multidrug Resistance Using Liquid Culture and Molecular Methods in Russia 英文参考文献.docVIP

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An Integrated Approach to Rapid Diagnosis of Tuberculosis and Multidrug Resistance Using Liquid Culture and Molecular Methods in Russia 英文参考文献.doc

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An Integrated Approach to Rapid Diagnosis of Tuberculosis and Multidrug Resistance Using Liquid Culture and Molecular Methods in Russia 英文参考文献

AnIntegratedApproachtoRapidDiagnosisof TuberculosisandMultidrugResistanceUsingLiquid CultureandMolecularMethodsinRussia YaninaBalabanova1,2*,FrancisDrobniewski1,VladyslavNikolayevskyy1,AnnikaKruuner1 ,Nadezhda Malomanova2,TatyanaSimak2,NailyaIlyina2,SvetlanaZakharova3,NatalyaLebedeva3,HeatherL. Alexander4,5,RickO’Brien4,HojoonSohn4,AnastasiaShakhmistova2,IvanFedorin2 1NationalMycobacteriumReferenceLaboratory,InstituteofCellandMolecularSciences,QueenMaryCollege,BartsandtheLondonSchoolofMedicine,Universityof London, London, United Kingdom, 2Samara Oblast Tuberculosis Dispensary, Samara, Russia, 3Samara City Tuberculosis Service, Samara, Russia, 4Foundation for InnovativeNewDiagnostic,Cointrin/Geneva,Switzerland,5USCentersforDiseaseControlandPrevention,DivisionofTBElimination,Atlanta,Georgia,UnitedStatesof America Abstract Objective:Toanalysethefeasibility,costandperformanceofrapidtuberculosis(TB)molecularandculturesystems,ina highmultidrug-resistantTB(MDRTB)middle-incomeregion(Samara,Russia)andprovideevidenceforWHOpolicychange. Methods:PerformanceandcostevaluationwasconductedtocomparetheBACTECTMMGITTM960systemforcultureand drugsusceptibilitytesting(DST)andmolecularsystemsforTBdiagnosis,resistancetoisoniazidandrifampin,andMDRTB identificationcomparedtoconventionalLowenstein-Jensencultureassays. Findings:698consecutivepatients(2487sputumsamples)withriskfactorsfordrug-resistanttuberculosiswererecruited. OverallM.tuberculosiscomplexculturepositivityrateswere31.6%(787/2487)inMGITand27.1%(675/2487)inLJ(90.5% and83.2%forsmear-positivespecimens).Intotal,809culturesof M.tuberculosiscomplexwereisolated byanymethod. Median time to detection was 14 days for MGIT and 36 days for LJ (10 and 33 days for smear positive specimens) and indirectDSTinMGITtook9dayscomparedto21daysonLJ.TherewasgoodconcordancebetweenDSTonLJandMGIT (96.8% for rifampin and 95.6% for isoniazid). Both molecular hybridization assay results correlated well with MGIT DST results,althoughmolecularassaysgen