Introduction: Multi-drug resistant tuberculosis (MDR-TB) that is the tuberculosis that is resistant to at least 2 of the first line anti-tuberculosis drugs is fatal infectious disease. Cases of MDR-TB are now increasing with 30,000 cases of MDR-TB reported in 2013 by national TB programme. Rapid diagnosis of MDR-TB is extremely important for rapid treatment of patient and to prevent spread of MDR-TB to other. BACTEC 960 system helps in rapid diagnosis but purchase of expensive instrument for the same is the limitation. However, the same purpose can be solved by use of semi-automated MGIT system. Aims and Objectives: Aim of this study is to do drug sensitivity testing of the first line anti-tuberculosis drugs with the use of semi-automated MGIT systems. 350 newly registered and suspected cases of tuberculosis in tertiary care hospital were included. Samples were processed for digestion and decontamination and inoculated in MGIT tubes and also on LJ medium. Reading was taken using semi-automated MGIT system. Positive tubes were confirmed by rapid test for M. tuberculosis and then drug sensitivity was performed. Result: Out of 350 samples, 62% were sputum; 33% were pleural fluid and rest 5% were lymph node, Ascetic fluid, CSF, pus. Average day of positivity by MGIT was 13 - 20 days as compared to 25 - 37 days by solid medium, which was statistically significant with p value < 0.01. MDR cases were 2% out of 350 samples. Conclusion: Manual MGIT System is a simple, efficient, safe to use diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for detection of fluorescence. The rapidity by which mycobacteria are detected is the most important advantage of the Manual MGIT. In areas with limited resources where purchase of expensive instruments such as the MGIT960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be a possibility.
References
[1]
(2014) Global TB Report.
[2]
Poojan, S., Amit, A., Maxine, C., Krishna, G.P., Abhilasha, K., Sabina, D., et al. (2015) The Application of GeneXpert MTB/RIF for Smear-Negative TB Diagnosis as Fee-Paying Service at a South Asian General Hospital. Tuberculosis Research and Treatment, 2015, Article ID: 102430.
[3]
(2012) Molecular Detection of Drug-Resistant Tuberculosis by Line Probe Assay: Laboratory Manual for Resource-Limited Settings. Foundation for Innovative New Diagnostics.
[4]
Rishi, S., Sinha, P., Malhotra, B. and Pal, N. (2007) A Comparative Study for the Detection of Mycobacteria by BACTEC MGIT 960, Lowenstein Jensen Media and Direct AFB Smear Examination. Indian Journal of Medical Microbiology, 25, 383-386.
https://doi.org/10.4103/0255-0857.37344
[5]
Rodrigues, C., Shenai, S., Sadani, M., Sukhadia, N., Jani, M., Ajbani, K., Sodha, A. and Mehta, A. (2009) Evaluation of the Bactec MGIT 960 TB System for Recovery and Identification of Mycobacterium tuberculosis Complex in a High through Put Tertiary Care Centre. Indian Journal of Medical Microbiology, 27, 217-221.
https://doi.org/10.4103/0255-0857.53203
[6]
Somoskovi, A. and Magyar, P. (1999) Comparison of Mycobacteria Growth Indicator Tube with MB Redox, Lowenstein-Jensen, and Middlebrook7H11 Media for the Recovery of Mycobacteria in Clinical Specimens. Journal of Clinical Microbiology, 37, 1366-1369.
[7]
Rusch-Gerdes, S., Pfyffer, G.E., Casal, M., Chadwic, M. and Siddiqi, S. (2006) Multicenter Laboratory Validation of the Bactec MGIT 960 Technique for Testing Susceptibilities of Mycobacterium tuberculosis to Classical Second-Line Drugs and Newer Antimicrobials. Journal of Clinical Microbiology, 44, 688-692.
https://doi.org/10.1128/JCM.44.3.688-692.2006
[8]
Anargyros, P., Astill, D.S.J. and Lim, L.S.I. (1990) Comparison of Improved BACTEC and Lowenstein-Jensen Media for Culture of Mycobacteria from Clinical Specimen. Journal of Clinical Microbiology, 28, 1288-1291.
[9]
Ardito, F., Posteraro, B., Sanguinetti, M., Zanetti, S. and Fadda, G. (2001) Evaluation of BACTEC Mycobacteria Growth Indicator Tube (MGIT960) Automated System for Drug Susceptibility Testing of Mycobacterium tuberculosis. Journal of Clinical Microbiology, 39, 4440-4444. https://doi.org/10.1128/JCM.39.12.4440-4444.2001
[10]
Palaci, M., Ueki, S.Y.M., Nakamura, S., Silva, D., Tellis, M.A., Curcio, M. and Silva, M.A.E. (1996) Evaluation of Mycobacteria Growth Indicator Tube for Recovery and Drug Susceptibility Testing of Mycobacterium tuberculosis Isolates from Respiratory Specimens. Journal of Clinical Microbiology, 34, 762-764.
[11]
Kruuner, A., Yates, D.M. and Drobniewski, F.A. (2006) Evaluation of MGIT 960-Based Antimicrobial Testing and Determination of Critical Concentrations of First- and Second-Line Antimicrobial Drugs with Drug-Resistant Clinical Strains of Mycobacterium tuberculosis. Journal of Clinical Microbiology, 44, 811-818.
[12]
Rodrigues, C., Shenai, S., Sadani, M., Sukhadia, N., Jani, M., Ajban, K., Sodha, A. and Mehta, A. (2009) Evaluation of the BACTEC MGIT 960TB System for the Recovery and Identification of Mycobacterium tuberculosis Complex in a High Volume Tertiary Care Centre. Indian Journal of Medical Microbiology, 27, 217-221.
[13]
Cohn, D.L., Bustreo, F. and Raviglione, M.C. (1997) Drug-Resistant Tuberculosis; Review of the Worldwide Situation and the WHO/IUATLD Global Surveillance Project. International Union against Tuberculosis and Lung Disease. Clinical Infectious Diseases, 24, S121-S130. https://doi.org/10.1093/clinids/24.Supplement_1.S121
[14]
Paramasivan, C.N., Venkataraman, P., Chandrasekaran,V., Bhat, S. and Narayan, P.R. (2002) Surveillance of Drug Resistance in Tuberculosis in Two Districts of South India. International Journal of Tuberculosis and Lung Disease, 6, 479-484.
[15]
Surendra, K.S., Gaurav, K., Brajesh, J., Ninoo, G., Arora, S.K., Deepak, G., Urvashi, S., Mahmud, H. and Vashisht, R.P. (2011) Prevalence of Multidrug Resistant Tuberculosis among Newly Diagnosed Cases of Sputum Positive Pulmonary Tuberculosis. Indian Journal of Medical Research, 133, 308-311.
