Second-line drug susceptibility breakpoints for Mycobacterium tuberculosis using the MODS assay.
Int J Tuberc Lung Dis
; 18(2): 227-32, 2014 Feb.
Article
in En
| MEDLINE
| ID: mdl-24429318
ABSTRACT
OBJECTIVE:
To establish breakpoint concentrations for the fluoroquinolones (moxifloxacin [MFX] and ofloxacin [OFX]) and injectable second-line drugs (amikacin [AMK], kanamycin [KM] and capreomycin [CPM]) using the microscopic observation drug susceptibility (MODS) assay.SETTING:
A multinational study conducted between February 2011 and August 2012 in Peru, India, Moldova and South Africa.DESIGN:
In the first phase, breakpoints for the fluoroquinolones and injectable second-line drugs (n = 58) were determined. In the second phase, MODS second-line drug susceptibility testing (DST) as an indirect test was compared to MGIT™ DST (n = 89). In the third (n = 30) and fourth (n = 156) phases, we determined the reproducibility and concordance of MODS second-line DST directly from sputum.RESULTS:
Breakpoints for MFX (0.5 µg/ml), OFX (1 µg/ml), AMK (2 µg/ml), KM (5 µg/ml) and CPM (2.5 µg/ml) were determined. In all phases, MODS results were highly concordant with MGIT DST. The few discrepancies suggest that the MODS breakpoint concentrations for some drugs may be too low.CONCLUSION:
MODS second-line DST yielded comparable results to MGIT second-line DST, and is thus a promising alternative. Further studies are needed to confirm the accuracy of the drug breakpoints and the reliability of MODS second-line DST as a direct test.
Full text:
1
Database:
MEDLINE
Main subject:
Tuberculosis, Pulmonary
/
Microbial Sensitivity Tests
/
Tuberculosis, Multidrug-Resistant
/
Drug Resistance, Multiple, Bacterial
/
Microscopy
/
Mycobacterium tuberculosis
/
Antitubercular Agents
Type of study:
Clinical_trials
/
Prognostic_studies
Limits:
Humans
Country/Region as subject:
Africa
/
America do sul
/
Asia
/
Europa
/
Peru
Language:
En
Journal:
Int J Tuberc Lung Dis
Year:
2014
Type:
Article
Affiliation country:
South Africa