Field assessment of the direct nitrate reductase assay for rapid detection of multidrug-resistant tuberculosis in Honduras.

Abstract

SETTING:

The national TB reference laboratory and four health care units connected to the national laboratory network in Honduras, Central America.

OBJECTIVE:

To evaluate the performance of the direct nitrate reductase assay (NRA) for rapid, low-cost detection of multidrug-resistant tuberculosis (MDR-TB) in a resource-limited setting.

DESIGN:

Consecutive smear-positive samples (n = 185) were prospectively analysed with NRA and compared to the proportion method on Löwenstein Jensen medium (PM-LJ) to detect resistance to isoniazid (INH) and rifampicin (RMP).

RESULTS:

The NRA sensitivity, specificity, positive and negative predictive values for INH and RMP were respectively 100%, 99%, 91%, 100% and 80%, 100%, 100%, 99%. Good agreement was observed between NRA and PM-LJ (κ > 0.8).

CONCLUSION:

The direct NRA is a reliable alternative for rapid and low-cost identification of MDR-TB cases in resource-limited settings.

• Authors: S Rosales, N Almendarez, H Membreño, S E Hoffner, L Pineda-Garcia
• Journal: The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease (Int J Tuberc Lung Dis) Vol. 15 Issue 9 Pg. 1206-10, i (Sep 2011) ISSN: 1815-7920 [Electronic] France
• PMID: 21943847 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antitubercular Agents
• Nitrate Reductase
• Isoniazid
• Rifampin

Topics

• Antitubercular Agents (pharmacology)
• Honduras
• Humans
• Isoniazid (pharmacology)
• Microbial Sensitivity Tests
• Nitrate Reductase (metabolism)
• Predictive Value of Tests
• Prospective Studies
• Rifampin (pharmacology)
• Sensitivity and Specificity
• Sputum (microbiology)
• Tuberculosis, Multidrug-Resistant (diagnosis, drug therapy, enzymology)