Molecular screening of multidrug-resistance tuberculosis by a designated public health laboratory in Taiwan

H. C. Lin, C. L. Perng, Y. W. Lai, F. G. Lin, C. J. Chiang, H. A. Lin, R. Jou, T. S. Chiueh

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Abstract

This manuscript describes our experience in early identifying MDR-TB cases in high-risk populations by setting up a single-referral molecular diagnosis laboratory in Taiwan. Taiwan Centers for Disease Control designated a single-referral laboratory to provide the GenoType MTBDRplus test for screening high-risk MDR-TB populations nationwide in 2012–2015. A total of 5,838 sputum specimens from 3,308 patients were tested within 3 days turnaround time. Compared with the conventional culture and drug susceptibility testing, the overall performance of the GenoType MTBDRplus test for detecting TB infection showed accuracy of 70.7%, sensitivity of 85.9%, specificity of 65.7%, positive predictive value of 45.5%, and negative predictive value of 93.3%. And the accuracy of detecting rifampin (RIF) resistance, isoniazid (INH) resistance, and MDR-TB (resistant to at least RIF and INH) were 96.5%, 95.2%, and 97.7%, respectively. MDR-TB contacts presented a higher rate of mutated codons 513–519, GenoType MTBDRplus banding pattern: rpoB WT3(−), and rpoB WT4(−) than the treatment failure group. The MDR-TB contact group also had a higher rate of inhA C15T mutation, banding pattern: inhA WT1(−), and inhA MUT1(+) than the recurrent group. Resistance profiles of MDR-TB isolates also varied geographically. The referral molecular diagnosis system contributed to rapid detection and initiation of appropriate therapy.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
DOIs
Publication statusAccepted/In press - Aug 24 2017
Externally publishedYes

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ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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