Korean J Clin Microbiol.  2008 Apr;11(1):43-48. 10.5145/KJCM.2008.11.1.43.

Comparison of Anti-mycobacterial Drug Susceptibility Test Results by Institutes and Methods

Affiliations
  • 1Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea. CCHL@pusan.ac.kr
  • 2National Masan Hospital, Masan, Korea.
  • 3Korean Institute of Tuberculosis, Seoul, Korea.

Abstract

BACKGROUND: The purposes of the current study were to evaluate the concordant rates of anti-mycobacterial drug susceptibility test (DST) results in different solid media performed in different institutes, and to determine reliable susceptible testing methods.
METHODS
One hundred and twenty two Mycobacterium tuberculosis strains were isolated from patients in A Hospital in 2005. DSTs were performed by the absolute concentration method using L?wenstein Jensen medium in both A Hospital (method A-1) and B Institute (method B-1) and by the proportion method using Middlebrook 7H10 agar in B Institute (method B-2). Nine drugs were used including isoniazid and rifampin. Sensitivity and specificity of each method were estimated by using the acceptable standard of 90% for isoniazid and rifampin and 80% for other drugs. The therapeutic outcomes of quinolone-administered patients were evaluated according to ofloxacin susceptibility results.
RESULTS
Method B-1 showed sensitivity and specificity levels over the acceptable standard levels for all drugs. Method B-2 showed specificity lower than the acceptable levels for rifampin and cycloserine. Method A-1 showed specificity lower than the acceptable levels for isoniazid, streptomycin, p-aminosalicylic acid, and ofloxacin and sensitivity lower than the acceptable levels for prothionamide and cycloserine. The concordance rates of therapeutic outcomes with method B-1, method B-2, and method A-1 were 77%, 74%, and 65%, respectively.
CONCLUSION
The drug susceptibility results for some drugs were discordant between the testing laboratories and media, requiring an urgent application of quality control programs to raise the reliability of anti-mycobacterial DST.

Keyword

Mycobacterium tuberculosis; Drug susceptibility tests; Culture Media

MeSH Terms

Academies and Institutes
Agar
Aminosalicylic Acid
Culture Media
Cycloserine
Humans
Isoniazid
Mycobacterium tuberculosis
Ofloxacin
Prothionamide
Quality Control
Rifampin
Sensitivity and Specificity
Streptomycin
Agar
Aminosalicylic Acid
Culture Media
Cycloserine
Isoniazid
Ofloxacin
Prothionamide
Rifampin
Streptomycin

Cited by  1 articles

Rapid Diagnosis of Tuberculosis and Multidrug Resistance Using a MGIT 960 System
Won-Jung Koh, Yousang Ko, Chang-Ki Kim, Kyung Sun Park, Nam Yong Lee
Ann Lab Med. 2012;32(4):264-269.    doi: 10.3343/alm.2012.32.4.264.


Reference

References

1. Kim BJ, Lee IH, Lee DH, Bai GH, Kong SJ, Lee SH, et al. The current status of multidrug-resistant tuberculosis in Korea. Tuberc Respir Dis. 2006; 60:404–11.
Article
2. Vareldzis BP, Grosset J, de Kantor I, Crofton J, Laszlo A, Felten M, et al. Drug-resistant tuberculosis: laboratory issues. World Health Organization recommendations. Tuber Lung Dis. 1994; 75:1–7.
3. Canetti G, Fox W, Khomenko A, Mahler HT, Menon NK, Mitchison DA, et al. Advances in techniques of testing mycobacterial drug sensitivity, and the use of sensitivity tests in tuberculosis control programmes. Bull World Health Organ. 1969; 41:21–43.
4. Clinical and Laboratory Standards Institute. Susceptibility Testing of Mycobacteria, Nocardiae, and Other Aerobic Actinomycetes; Approved Standard. NCCLS document M24-A. Wayne, PA; NCCLS. 2003.
5. Mitchison DA. Drug resistance in tuberculosis. Eur Respir J. 2005; 25:376–9.
Article
6. Kim SJ. Drug-susceptibility testing in tuberculosis: methods and reliability of results. Eur Respir J. 2005; 25:564–9.
Article
7. Laszlo A, Rahman M, Espinal M, Raviglione M. WHO/IUATLD Network of Supranational Reference Laboratories. Quality assurance programme for drug susceptibility testing of Mycobacterium tuberculosis in the WHO/IUATLD Supranational Reference Laboratory Network: five rounds of proficiency testing, 1994–1998. Int J Tuberc Lung Dis. 2002; 6:748–56.
8. Mitarai S. The external quality assessment for Mycobacterium tuberculosis drug susceptibility testing by proficiency testing panel to the commercial laboratories. Kekkaku. 2005; 80:349–58.
9. World Health Organization. Guidelines for drug susceptibility testing for second-line anti-tuberculosis drufs for DOTS-PLUS. Publication No. WHO/CDS/TB/2001.288. Geneva; World Health Organization. 2001.
10. Pfyffer GE, Bonato DA, Ebrahimzadeh A, Gross W, Hotaling J, Kornblum J, et al. Multicenter laboratory validation of susceptibility testing of Mycobacterium tuberculosis against classical second-line and newer antimicrobial drugs by using the radiometric BACTEC 460 technique and the proportion method with solid media. J Clin Microbiol. 1999; 37:3179–86.
11. Bai GH, Kim SJ, Chang CL. National and Regional Tuberculosis Reference Laboratories. Proficiency analysis of drug susceptibility testing by national-level tuberculosis reference laboratories from 1995 to 2003. J Clin Microbiol. 2007; 45:3626–30.
Article
12. Tomioka H. Prospects for development of new antimycobacterial drugs. J Infect Chemother. 2000; 6:8–20.
Article
13. Tomioka H. Prospects for development of new antimycobacterial drugs, with special reference to a new benzoxazinorifamycin, KRM-1648. Arch Immunol Ther Exp (Warsz). 2000; 48:183–8.
Full Text Links
  • KJCM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr