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  • Rapid diagnosis of pulmonary tuberculosis and detection of drug resistance by combined simultaneous amplification testing and reverse dot blot

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Original article
Rapid diagnosis of pulmonary tuberculosis and detection of drug resistance by combined simultaneous amplification testing and reverse dot blot
  1. Yiwen Chen1,
  2. Lahong Zhang2,
  3. Liquan Hong2,
  4. Xian Luo2,
  5. Juping Chen3,
  6. Leiming Tang3,
  7. Jiahuan Chen3,
  8. Xia Liu2,
  9. Zhaojun Chen2
  1. 1 Hangzhou Normal University Affiliated Hospital (Clinical College), Hangzhou, China
  2. 2 Clinical Laboratory Department, Hangzhou Normal University Affiliated Hospital, Hangzhou, China
  3. 3 Tuberculosis Laboratory Department, Hangzhou Normal University Affiliated Hospital, Hangzhou, China
  1. Correspondence to Professor Zhaojun Chen, Department of Clinical Laboratory, Hangzhou Normal University Affiliated Hospital, Hangzhou, Zhejiang Province 310015, China; hzczj2006{at}163.com

Abstract

Aims Making a correct and rapid diagnosis is essential for managing pulmonary tuberculosis (PTB), particularly multidrug-resistant tuberculosis. We aimed to evaluate the efficacy of the combination of simultaneous amplification testing (SAT) and reverse dot blot (RDB) for the rapid detection of Mycobacterium tuberculosis (MTB) and drug-resistant mutants in respiratory samples.

Methods 225 suspected PTB and 32 non-TB pulmonary disease samples were collected. All sputum samples were sent for acid-fast bacilli smear, SAT, culture and drug susceptibility testing (DST) by the BACTECTM MGITTM 960 system. 53 PTB samples were tested by both RDB and DNA sequencing to identify drug resistance genes and mutated sites.

Results The SAT positive rate (64.9%) was higher than the culture positive rate (55.1%), with a coincidence rate of 83.7%. The sensitivity and specificity of SAT for diagnosing PTB were 66.7% and 100%, respectively, while those for culture were 53.9% and 84.2%, respectively. RDB has high sensitivity and specificity in identifying drug resistance genes and mutated sites. The results of RDB correlated well with those of DST and DNA sequencing, with coincidence rates of 92.5% and 98.1%, respectively.

Conclusions The combination of SAT and RDB is promising for rapidly detecting PTB and monitoring drug resistance in clinical laboratories.

  • mycobacterium tuberculosis
  • SAT
  • RDB
  • rapid diagnosis
  • drug-resistance

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/jclinpath-2017-204714

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    Footnotes

    • Handling editor Tony Mazzulli.

    • Contributors YC, XL, JC, LT, JC and XL did the experiments. ZC and LH designed the study. YC and LZ wrote the manuscript. All authors read and approved the final manuscript.

    • Funding This work was supported by Hangzhou Science and Technology Development Plans (20140633B11) and Zhejiang Medical and Health Technology Program (2014ZDA018).

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The Ethics Committee of Hangzhou Normal University Affiliated Hospital, China.

    • Provenance and peer review Not commissioned; internally peer reviewed.