AN INTEGRATED APPROACH OF RAPID PHENOTYPIC METHOD AND MOLECULAR DIAGNOSTIC TECHNIQUE FOR DIAGNOSIS OF DRUG RESISTANT TUBERCULOSIS

U.D. RATHOD¹*, AMEETA JOSHI², NILMA HIRANI³, ABHAY CHOWDHARY^4
1Grant Medical College and Sir JJ Hospital, J.J Marg, Mumbai, Maharashtra 400008, India
²Grant Medical College and Sir JJ Hospital, J.J Marg, Mumbai, Maharashtra 400008, India
³Grant Medical College and Sir JJ Hospital, J.J Marg, Mumbai, Maharashtra 400008, India
⁴Grant Medical College and Sir JJ Hospital, J.J Marg, Mumbai, Maharashtra 400008, India
* Corresponding Author : drkumavat1947@gmail.com

Received : 08-08-2017     Accepted : 14-08-2017     Published : 28-08-2017
Volume : 9     Issue : 8       Pages : 919 - 923
Int J Microbiol Res 9.8 (2017):919-923

Keywords : Drug resistance, RNTCP, Tuberculosis, Line probe assay, Rifampicin
Academic Editor : Dr Ranjana Hawaldar, Shivanna Vijaya, Kaup Soumya, Roy Arindam, Garima Kapoor
Conflict of Interest : None declared
Acknowledgements/Funding : Authors acknowledge the technical support of Foundation for Innovative New Diagnostics (FIND), India in the study
Author Contribution : All author equally contributed

Drug Resistant tuberculosis(DR-TB) is a worldwide problem and to speed up diagnosis, to standardised testing procedures, scaling up management and surveillance of DR-TB in high throughput laboratories, genotypic or molecular methods have considerable advantages. Optimum utilization of rapid phenotypic method and liquid culture system MIGIT 960 (mycobacterial growth indicator tube) for culture and drug susceptibility testing (DST) of second line drugs for tuberculosis(TB), could help provide fast, reliable and accurate results for patient care, since our laboratory have all these facilities simultaneously. Passive case finding along can lead to missed cases or delayed diagnosis. Enhanced outstretched activities to detect more TB cases are critical to universal assess. We analysed percentage of MDR, pre-XDR and XDR cases of tuberculosis for presumptive tuberculosis, presumptive MDR and presumptive XDR patients, according to recent changes in RNTCP guidelines for case finding and diagnostic strategy to optimise treatment regime. To conclude, drug-resistant tuberculosis (DR TB) poses a significant threat to human health. MTBDR assay, which fits easily in the workflow of a routine laboratory, with effective planning and logistics, simultaneous use of combination of molecular based technologies and rapid phenotypic method can be successfully introduced into a reference laboratory setting with high throughput laboratories and high incidence country. Consequently, use of both molecular and phenotypic methods, will not only reduce the heavy work load of reference laboratories but also improves the quality of work done by the staff and thereby assuring the quality of reports released.

1. World Health Organization (2008) Global Tuberculosis Control-Epidemiology, Strategy, Financing; World Health Organization: Geneva, Switzerland.
2. Brossier F., Veziris N., Truffot-Pernot C., Jarlier V. and Sougakoff W. (2006) Journal of Clinical Microbiology, 44(10),3659-3664.
3. Li J., Xin J., Zhang L., Jiang .L, Cao H and Li L. (2012) International journal of medical sciences, 9(2),148.
4. Edwards K.J., Metherell L.A., Yates M. and Saunders N.A. (2001) Journal of clinical microbiology, 39(9),3350-2.
5. El-Hajj H.H., Marras S.A., Tyagi S., Kramer F.R. and Alland D. (2001) Journal of clinical microbiology, 39(11), 4131-7.
6. Ahmad S., Mokaddas E. and Fares E. (2002) Diagnostic microbiology and infectious disease, 44(3),245-52.
7. Mani C., Selvakumar N., Narayanan S. and Narayanan P.R. (2001) Journal of clinical microbiology, 39(8), 2987-90.
8. Banerjee A., Dubnau E., Quemard A., Balasubramanian V., Um K.S., Wilson T., Collins D., De Lisle G. and Jacobs Jr W.R. (1994) InhA, a gene encoding a target for isoniazid and ethionamide in Mycobacterium tuberculosis. Science-AAAS-Weekly Paper Edition-including Guide to Scientific Information, 263(5144), 227-9.
9. Heym B., Zhang Y., Poulet S., Young D. and Cole S.T. (1993) Journal of bacteriology, 175(13),4255-9.
10. Herrera-León L., Molina T., Saíz P., Sáez-Nieto J.A. and Jiménez M.S. (2005) Antimicrobial agents and chemotherapy, 49(1),144-7.
11. Lavender C., Globan M., Sievers A., Billman-Jacobe H. and Fyfe J. (2005) Antimicrobial agents and chemotherapy, 49(10), 4068-74.
12. Leung E.T., Ho P.L., Yuen K.Y., Woo W.L., Lam T.H., Kao R.Y., Seto W.H. and Yam W.C. (2006) Antimicrobial agents and chemotherapy, 50(3),1075-8.
13. Morlock G.P., Metchock B., Sikes D., Crawford J.T. and Cooksey R.C. (2003) Antimicrobial agents and chemotherapy, 47(12), 3799-805.
14. Park H., Song E.J., Song E.S., Lee E.Y., Kim C.M., Jeong S.H., Shin J.H., Jeong J., Kim S. and Park Y.K.V., Bai G.H. (2006) Journal of clinical microbiology, 44(5), 1619-24.
15. Parmarth Chandane, Ira Shah (2016) The Journal of Association of Chest Physicians, 4(1):33-35. DOI 10.4103/2320-8775.159869.
16. India, Ministry. "Technical and Operational Guidelines for TB Control in India 2016: Central TB Division". Tbcindia.nic.in.2017. Web. 5 Mar. 2017.
17. Chaudhuri AD (2017) The Journal of Association of Chest Physicians, 5(1), 1.
18. Kent P.T. and Kubica G.P. (1985) Public health mycobacteriology: a guide for the level III laboratory. US Department of Health and Human Services, Public Health Service, Centres for Disease Control.
19. Revised National Tuberculosis Control Programme (2012) Guideline on programmatic management of drug resistant TB (PMDT) in India. Ministry of Health & Family Welfare, New Delhi, India.
a. http://tbcindi.nic.in/pdfs/guidelines 2012.pdf.
20. Hain Lifescience GmbH. GenoType MTBDRplus, version 2.0 product insert. Nehren, Germany. “zjm1846.”.http://www.hain-lifescience. de/en/ instructions-for-use.html. Scribd, Scribd, es.scribd.com/document/307624213/zjm1846
21. World Health Organization (2008) Molecular line probe assay for rapid screening of patients at risk of multidrug-resistant tuberculosis (MDRTB). World Health Organization: Geneva, Switzerland.
a. Switzerland.http://www.who.int/tb/features_archive/policy_statement.pdf.
22. Rawat R., Whitty A. and Tonge P.J. (2003) Proceedings of the National Academy of Sciences, 100(24),13881-6.
23. Lavender C., Globan M., Sievers A., Billman-Jacobe H. and Fyfe J. (2005) Antimicrobial agents and chemotherapy, 49(10),4068-74.
24. Leung E.T., Ho P.L., Yuen K.Y., Woo W.L., Lam T.H., Kao R.Y., Seto W.H. and Yam W.C. (2006) Antimicrobial agents and chemotherapy, 50(3),1075-8.
25. Morlock G.P., Metchock B., Sikes D., Crawford J.T. and Cooksey R.C. (2003) Antimicrobial agents and chemotherapy, 47(12),3799-805.
26. Rinder H. (2001) Journal of medical microbiology, 50(12),1018-20.
27. Mokrousov I., Narvskaya O., Otten T., Limeschenko E., Steklova L. and Vyshnevskiy B. (2002) Antimicrobial agents and chemotherapy, 46(5),1417-24.
28. Palomino J.C. and Martin A. (2014) Antibiotic, 3(3), 317-40.