rapid molecular detection of rifampicin resistance facilitates early diagnosis and treatment of multi-drug resistant tuberculosis case control study快速分子检测利福平耐药性的促进早期诊断和治疗耐多药结核病病例对照研究.pdfVIP

Rapid Molecular Detection of Rifampicin Resistance Facilitates Early Diagnosis and Treatment of Multi-Drug Resistant Tuberculosis: Case Control Study 1 1 1 1¤c 1,2¤a Philly O’Riordan , Uli Schwab , Sarah Logan , Graham Cooke , Robert J. Wilkinson , Robert N. 1 1 3 1,2 1¤b Davidson , Paul Bassett , Robert Wall , Geoffrey Pasvol , Katie L. Flanagan * 1 Department of Infection and Tropical Medicine, Lister Unit, Northwick Park Hospital, Harrow, Middlesex, United Kingdom, 2 Wellcome Centre for Clinical Tropical Medicine, Division of Medicine, Imperial College London, London, United Kingdom, 3 Department of Medical Microbiology, Northwick Park Hospital, Harrow, Middlesex, United Kingdom Abstract Background: Multi-drug resistant tuberculosis (MDR-TB) is a major public health concern since diagnosis is often delayed, increasing the risk of spread to the community and health care workers. Treatment is prolonged, and the total cost of treating a single case is high. Diagnosis has traditionally relied upon clinical suspicion, based on risk factors and culture with sensitivity testing, a process that can take weeks or months. Rapid diagnostic molecular techniques have the potential to shorten the time to commencing appropriate therapy, but have not been put to the test under field conditions. Methodology/Principal Findings: This retrospective case-control study aimed to identify risk factors for MDR-TB, and analyse the impact of testing for rifampicin resistance using RNA polymerase B (rpoB) mutations as a surrogate for MDR-TB.