True rifampicin resistance missed by the MGIT: prevalence of this pheno/genotype in the UK and Ireland after 18 month surveillance

被引:12
作者
Gonzalo, X. [1 ,2 ]
Claxton, P. [3 ]
Brown, T. [1 ]
Montgomery, L. [4 ]
Fitzgibbon, M. [4 ]
Laurenson, I. [3 ]
Drobniewski, F. [1 ,2 ]
机构
[1] Publ Hlth England, Natl Mycobacterium Reference Lab, London, England
[2] Imperial Coll, Hammersmith Hosp, Dept Infect Dis, Commonwealth Bldg,Du Cane Rd, London W12 0NN, England
[3] Royal Infirm Edinburgh NHS Trust, Clin Microbiol, Scottish Mycobacteria Reference Lab, Edinburgh, Midlothian, Scotland
[4] St James Hosp, Irish Mycobacteria Reference Lab, Dublin, Ireland
关键词
Drug susceptibility testing; Genotypic dst; Line probe assay; Mycobacterium tuberculosis; Proportion method; Resistance ratio; Rifampicin; rpoB sequencing; Very major error; MYCOBACTERIUM-TUBERCULOSIS; RPOB MUTATIONS; SUSCEPTIBILITY; ASSAYS; DRUGS; TESTS; PLATE; TB;
D O I
10.1016/j.cmi.2016.11.015
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives: To characterize rifampicin-resistant strains missed by the Mycobacteria Growth Indicator Tube (MGIT) 960 system but not by egg-based media in the UK and Ireland and to ascertain their prevalence. Methods: All strains sent for second-line susceptibility testing were prospectively collected. Drug Susceptibility Testing was performed by Resistance Ratio (RR), Proportion Method (PM), MGIT 960 and MIC determination by microdilution. Rifampicin-resistance-conferring mutations were detected with line probe assays and sequencing. At the end of the study period, retrospective archived strains from 2010 to 2014 showing key mutations were analysed phenotypically and genotypically. Results: Seventeen of 7234 prospective isolates were included. All of them were susceptible by MGIT. One was borderline by RR (MIC to rifampicin of 4 mg/L) and was resistant by PM. Eight were resistant and eight were highly resistant on RR. These 16 isolates had MICs between 1 and 8 mg/L on microdilution. With PM, 16/17 were susceptible to rifampicin. 17/17 had mutations in the rpoB gene. D516Y was the mutation most frequently found (13/17). Retrospectively, ten additional strains with key genotypes were found in our collection: 6/10 were susceptible in the MGIT and resistant in RR. Of the 27 studied strains, the MGIT only detected resistance in four. Conclusions: Rifampicin resistance is missed by the MGIT system. In the UK and Ireland the prevalence of these strains is low. The introduction of routine molecular testing would detect false susceptibility. Further research is needed to ascertain the role of these strains in clinical failure and their prevalence in other settings. (C) 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:260 / 263
页数:4
相关论文
共 29 条
[1]   A comparison of the SensititreA® MYCOTB panel and the agar proportion method for the susceptibility testing of Mycobacterium tuberculosis [J].
Abuali, M. M. ;
Katariwala, R. ;
LaBombardi, V. J. .
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2012, 31 (05) :835-839
[2]  
[Anonymous], 2006, Koneman's color atlas and text book of diagnostic microbiology, V6th
[3]  
[Anonymous], 2009, Treatment of tuberculosis guidelines
[4]  
[Anonymous], 2013, TUB UK ANN REP TUB S
[5]  
Anuwatnonthakate Amornrat, 2013, Glob J Health Sci, V5, P60, DOI 10.5539/gjhs.v5n6p60
[6]   Survival of patients with multidrug-resistant TB in Eastern Europe: what makes a difference? [J].
Balabanova, Yanina ;
Ignatyeva, Olga ;
Fiebig, Lena ;
Riekstina, Vija ;
Danilovits, Manfred ;
Jaama, Kadri ;
Davidaviciene, Edita ;
Radiulyte, Birute ;
Popa, Christina Marcela ;
Nikolayevskyy, Vladyslav ;
Drobniewski, Francis .
THORAX, 2016, 71 (09) :854-861
[7]  
Brown T. J., 2008, V465, P371, DOI 10.1007/978-1-59745-207-6_25
[8]  
CANETTI G, 1969, B WORLD HEALTH ORGAN, V41, P21
[9]   Vitamin D-Binding Protein Directs Monocyte Responses to 25-Hydroxy- and 1,25-Dihydroxyvitamin D [J].
Chun, Rene F. ;
Lauridsen, Anna L. ;
Suon, Lizabeth ;
Zella, Lee A. ;
Pike, J. Wesley ;
Modlin, Robert L. ;
Martineau, Adrian R. ;
Wilkinson, Robert J. ;
Adams, John ;
Hewison, Martin .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2010, 95 (07) :3368-3376
[10]  
Clinical and Laboratory Standards Institute (CLSI), 2011, M24A2 CLSI