Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Cochrane Review of RDT for diagnosis of drug resistant TB

30.10.2014

Researchers from the Cochrane Infectious Diseases Group, hosted at LSTM, have conducted an independent review to examine the diagnostic accuracy of the GenoType® MTBDRsl assay for the detection of resistance to second-line anti-tuberculosis drugs.

While there are a number of different drugs available to people suffering from tuberculosis (TB), resistance to these drugs is a growing problem. People suffering from a drug-resistant strain of TB are more likely to die from the disease, and require treatment with what are described as “second-line” drugs. These drugs can cause more side effects and must be taken for longer.


A rapid and accurate test that could identify people with resistant TB, including a type of TB that is resistant to almost all anti-TB drugs, called XDR-TB, is likely to improve patient care and reduce the spread of drug-resistant TB.

GenoType® MTBDRsl is the only rapid test that detects resistance to second-line fluoroquinolone (FQ) drugs and second-line injectable drugs (SLID) as well as detecting XDR-TB. MTBDRsl can be performed on TB bacteria grown from sputum, which is called indirect testing and can take a long time, or can be performed immediately on sputum, which is called direct testing.

The authors reviewed the results from 21 studies, 14 of which reported the accuracy of MTBDRsl with direct testing, five of which looked at indirect testing and two of which looked at both.

By indirect testing, the test detected 83% of people with FQ resistance and rarely gave a positive result for people without resistance. In a population of 1000 people, where 170 have FQ resistance, MTBDRsl will correctly identify 141 people with FQ resistance and miss 29 people.

Of the 830 people who do not have FQ resistance, the test will correctly classify 811 people as not having FQ resistance and misclassify 19 people as having resistance. By direct testing, the test detected 85% of people with FQ resistance and rarely gave a positive result for people without resistance.

By indirect testing, the test detected 77% of people with SLID resistance and rarely gave a positive result for people without resistance. In a population of 1000 people, where 230 have SLID resistance, MTBDRsl will correctly identify 177 people with SLID resistance and miss 53 people.

Of the 770 people who do not have SLID resistance, the test will correctly classify 766 people as not having SLID resistance and misclassify four people as having resistance. By direct testing, the test detected 94% of people with SLID resistance and rarely gave a positive result for people without resistance.

By indirect testing, the test detected 71% of people with XDR-TB and rarely gave a positive result for people without XDR-TB. In a population of 1000 people, where 80 have XDR-TB, MTBDRsl will correctly identify 57 people with XDR-TB and miss 23 people. In this same population of 1000 people, where 920 do not have XDR-TB, the test will correctly classify 909 people as not having XDR-TB and misclassify 11 people as having XDR-TB. There was insufficient evidence recorded to determine the accuracy of MTBDRsl by direct testing for XDR-TB.

Dr Grant Theron from The University of Cape Town, lead author of the review said: “Our review shows that in adults with TB, a positive result for second-line drugs, either fluoroquinolone or injectable, or XDR-TB can be treated with confidence. However, given that a number of people tested negative while having a resistant strain, clinicians may still want to carry out conventional testing in some cases.”

Gill Wareing | EurekAlert!
Further information:
http://www.lstmed.ac.uk/about-lstm/news-and-media/latest-news/cochrane-review-of-rdt-for-diagnosis-of-drug-resistant-tb

More articles from Health and Medicine:

nachricht 'Living bandages': NUST MISIS scientists develop biocompatible anti-burn nanofibers
16.02.2018 | National University of Science and Technology MISIS

nachricht New process allows tailor-made malaria research
16.02.2018 | Eberhard Karls Universität Tübingen

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: In best circles: First integrated circuit from self-assembled polymer

For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.

In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

Im Focus: Hybrid optics bring color imaging using ultrathin metalenses into focus

For photographers and scientists, lenses are lifesavers. They reflect and refract light, making possible the imaging systems that drive discovery through the microscope and preserve history through cameras.

But today's glass-based lenses are bulky and resist miniaturization. Next-generation technologies, such as ultrathin cameras or tiny microscopes, require...

Im Focus: Stem cell divisions in the adult brain seen for the first time

Scientists from the University of Zurich have succeeded for the first time in tracking individual stem cells and their neuronal progeny over months within the intact adult brain. This study sheds light on how new neurons are produced throughout life.

The generation of new nerve cells was once thought to taper off at the end of embryonic development. However, recent research has shown that the adult brain...

Im Focus: Interference as a new method for cooling quantum devices

Theoretical physicists propose to use negative interference to control heat flow in quantum devices. Study published in Physical Review Letters

Quantum computer parts are sensitive and need to be cooled to very low temperatures. Their tiny size makes them particularly susceptible to a temperature...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

Rare find from the deep sea

20.02.2018 | Life Sciences

In living color: Brightly-colored bacteria could be used to 'grow' paints and coatings

20.02.2018 | Life Sciences

Observing and controlling ultrafast processes with attosecond resolution

20.02.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>