Diagnostic accuracy and usefulness of the Genotype MTBDRplus assay in diagnosing multidrug-resistant tuberculosis in Cameroon: a cross-sectional study

Abstract Background Drug-resistant tuberculosis, especially multidrug-resistant tuberculosis (MDR-TB), is a major public health problem. Effective management of MDR-TB relies on accurate and rapid diagnosis. In this study, we assessed the diagnostic accuracy of the Genotype MTBDRplus assay in diagno...

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Main Authors: Ngu Njei Abanda, Josiane Yvonne Djieugoué, Eunjung Lim, Eric Walter Pefura-Yone, Wilfred Fon Mbacham, Guy Vernet, Veronique Mbeng Penlap, Sara Irene Eyangoh, Diane Wallace Taylor, Rose Gana Fomban Leke
Format: Article
Language:English
Published: BMC 2017-05-01
Series:BMC Infectious Diseases
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Online Access:http://link.springer.com/article/10.1186/s12879-017-2489-3
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author Ngu Njei Abanda
Josiane Yvonne Djieugoué
Eunjung Lim
Eric Walter Pefura-Yone
Wilfred Fon Mbacham
Guy Vernet
Veronique Mbeng Penlap
Sara Irene Eyangoh
Diane Wallace Taylor
Rose Gana Fomban Leke
author_facet Ngu Njei Abanda
Josiane Yvonne Djieugoué
Eunjung Lim
Eric Walter Pefura-Yone
Wilfred Fon Mbacham
Guy Vernet
Veronique Mbeng Penlap
Sara Irene Eyangoh
Diane Wallace Taylor
Rose Gana Fomban Leke
author_sort Ngu Njei Abanda
collection DOAJ
description Abstract Background Drug-resistant tuberculosis, especially multidrug-resistant tuberculosis (MDR-TB), is a major public health problem. Effective management of MDR-TB relies on accurate and rapid diagnosis. In this study, we assessed the diagnostic accuracy of the Genotype MTBDRplus assay in diagnosing MDR-TB in Cameroon, and then discuss on its utility within the diagnostic algorithm for MDR-TB. Methods In this cross-sectional study, 225 isolates of Mycobacterium tuberculosis cultured from sputum samples collected from new and previously treated pulmonary tuberculosis patients in Cameroon were used to determine the accuracy of the Genotype MTBDRplus assay. We compared the results of the Genotype MTBDRplus assay with those from the automated liquid culture BACTEC MGIT 960 SIRE system for sensitivity, specificity, and degree of agreement. The pattern of mutations associated with resistance to RIF and INH were also analyzed. Results The Genotype MTBDRplus assay correctly identified Rifampicin (RIF) resistance in 48/49 isolates (sensitivity, 98% [CI, 89%–100%]), Isoniazid (INH) resistance in 55/60 isolates (sensitivity 92% [CI, 82%–96%]), and MDR-TB in 46/49 (sensitivity, 94% [CI, 83%–98%]). The specificity for the detection of RIF-resistant and MDR-TB cases was 100% (CI, 98%–100%), while that of INH resistance was 99% (CI, 97%–100%). The agreement between the two tests for the detection of MDR-TB was very good (Kappa = 0.96 [CI, 0.92–1.00]). Among the 3 missed MDR-TB cases, the Genotype MTBDRplus assay classified two samples as RIF-monoresistant and one as INH monoresistant. The most frequent mutations detected by the Genotype MTBDRplus assay was the rpoB S531 L MUT3 41/49 (84%) in RIF-resistant isolates, and the KatG S315 T1 (MUT1) 35/55 (64%) and inhA C15T (MUT1) 20/55 (36%) mutations in INH-resistant isolates. Conclusion The Genotype MTBDRplus assay had good accuracy and could be used for the diagnosis of MDR-TB in Cameroon. For routine MDR-TB diagnosis, this assay could be used for Mycobacterium tuberculosis cultures containing contaminants, to complement culture-based drug susceptibility testing or to determine drug resistant mutations.
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spelling doaj.art-8a91383ee9ec4d81840b6d3d32693a1c2022-12-21T18:59:15ZengBMCBMC Infectious Diseases1471-23342017-05-0117111010.1186/s12879-017-2489-3Diagnostic accuracy and usefulness of the Genotype MTBDRplus assay in diagnosing multidrug-resistant tuberculosis in Cameroon: a cross-sectional studyNgu Njei Abanda0Josiane Yvonne Djieugoué1Eunjung Lim2Eric Walter Pefura-Yone3Wilfred Fon Mbacham4Guy Vernet5Veronique Mbeng Penlap6Sara Irene Eyangoh7Diane Wallace Taylor8Rose Gana Fomban Leke9Biotechnology Centre, University of Yaounde IMycobacteriology Service, Centre Pasteur of CameroonOffice of Biostatistics and Quantitative Health Sciences, University of HawaiiPneumology service, Yaounde Jamot HospitalThe Biotechnology Centre, University of Yaoundé 1Virology Service, Centre Pasteur of CameroonLaboratory for Tuberculosis Research (LTR), Biotechnology Centre (BTC)-Nkolbison, University of Yaoundé IMycobacteriology Service, Centre Pasteur of CameroonDepartment of Tropical Medicine, Medical Microbiology and Pharmacology, University of HawaiiLaboratory of Immunology and Parasitology, the Biotechnology Centre, University of Yaoundé 1Abstract Background Drug-resistant tuberculosis, especially multidrug-resistant tuberculosis (MDR-TB), is a major public health problem. Effective management of MDR-TB relies on accurate and rapid diagnosis. In this study, we assessed the diagnostic accuracy of the Genotype MTBDRplus assay in diagnosing MDR-TB in Cameroon, and then discuss on its utility within the diagnostic algorithm for MDR-TB. Methods In this cross-sectional study, 225 isolates of Mycobacterium tuberculosis cultured from sputum samples collected from new and previously treated pulmonary tuberculosis patients in Cameroon were used to determine the accuracy of the Genotype MTBDRplus assay. We compared the results of the Genotype MTBDRplus assay with those from the automated liquid culture BACTEC MGIT 960 SIRE system for sensitivity, specificity, and degree of agreement. The pattern of mutations associated with resistance to RIF and INH were also analyzed. Results The Genotype MTBDRplus assay correctly identified Rifampicin (RIF) resistance in 48/49 isolates (sensitivity, 98% [CI, 89%–100%]), Isoniazid (INH) resistance in 55/60 isolates (sensitivity 92% [CI, 82%–96%]), and MDR-TB in 46/49 (sensitivity, 94% [CI, 83%–98%]). The specificity for the detection of RIF-resistant and MDR-TB cases was 100% (CI, 98%–100%), while that of INH resistance was 99% (CI, 97%–100%). The agreement between the two tests for the detection of MDR-TB was very good (Kappa = 0.96 [CI, 0.92–1.00]). Among the 3 missed MDR-TB cases, the Genotype MTBDRplus assay classified two samples as RIF-monoresistant and one as INH monoresistant. The most frequent mutations detected by the Genotype MTBDRplus assay was the rpoB S531 L MUT3 41/49 (84%) in RIF-resistant isolates, and the KatG S315 T1 (MUT1) 35/55 (64%) and inhA C15T (MUT1) 20/55 (36%) mutations in INH-resistant isolates. Conclusion The Genotype MTBDRplus assay had good accuracy and could be used for the diagnosis of MDR-TB in Cameroon. For routine MDR-TB diagnosis, this assay could be used for Mycobacterium tuberculosis cultures containing contaminants, to complement culture-based drug susceptibility testing or to determine drug resistant mutations.http://link.springer.com/article/10.1186/s12879-017-2489-3Multidrug-resistant tuberculosis (MDR-TB)Genotype MTBDRplus assayPulmonary tuberculosisCameroon. InhA promoter mutationKatG codon 315 mutationrpoB mutations
spellingShingle Ngu Njei Abanda
Josiane Yvonne Djieugoué
Eunjung Lim
Eric Walter Pefura-Yone
Wilfred Fon Mbacham
Guy Vernet
Veronique Mbeng Penlap
Sara Irene Eyangoh
Diane Wallace Taylor
Rose Gana Fomban Leke
Diagnostic accuracy and usefulness of the Genotype MTBDRplus assay in diagnosing multidrug-resistant tuberculosis in Cameroon: a cross-sectional study
BMC Infectious Diseases
Multidrug-resistant tuberculosis (MDR-TB)
Genotype MTBDRplus assay
Pulmonary tuberculosis
Cameroon. InhA promoter mutation
KatG codon 315 mutation
rpoB mutations
title Diagnostic accuracy and usefulness of the Genotype MTBDRplus assay in diagnosing multidrug-resistant tuberculosis in Cameroon: a cross-sectional study
title_full Diagnostic accuracy and usefulness of the Genotype MTBDRplus assay in diagnosing multidrug-resistant tuberculosis in Cameroon: a cross-sectional study
title_fullStr Diagnostic accuracy and usefulness of the Genotype MTBDRplus assay in diagnosing multidrug-resistant tuberculosis in Cameroon: a cross-sectional study
title_full_unstemmed Diagnostic accuracy and usefulness of the Genotype MTBDRplus assay in diagnosing multidrug-resistant tuberculosis in Cameroon: a cross-sectional study
title_short Diagnostic accuracy and usefulness of the Genotype MTBDRplus assay in diagnosing multidrug-resistant tuberculosis in Cameroon: a cross-sectional study
title_sort diagnostic accuracy and usefulness of the genotype mtbdrplus assay in diagnosing multidrug resistant tuberculosis in cameroon a cross sectional study
topic Multidrug-resistant tuberculosis (MDR-TB)
Genotype MTBDRplus assay
Pulmonary tuberculosis
Cameroon. InhA promoter mutation
KatG codon 315 mutation
rpoB mutations
url http://link.springer.com/article/10.1186/s12879-017-2489-3
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