Mikobakterilerin majör antitüberküloz ilaçlara duyarlılıǧının otomatize bactec MGIT 960 sistemi ile araştırılması ve radyometrik bactec 460 TB sistemi ile karşılaştırılması
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Date
2009-07
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Ankara Mikrobioloji Derneği
Abstract
Bu çalışmada 100 adet Mycobacterium tuberculosis klinik izolatının, tüberküloz tedavisinde kullanılan 4 majör ilacın [streptomisin (STR), izoniazid (INH), rifampin (RIF) ve ethambutol (EMB)] kritik konsantrasyonlarındaki duyarlılık sonuçları tam otomatize BACTEC MGIT 960 (Becton Dickinson, Cockeysville, Md.) sisteminde çalışılmış ve radyometrik BACTEC 460 TB (Becton Dickinson, Sparks, Md.) sisteminde elde edilen sonuçlar ile karşılaştırılmıştır. BACTEC 460 TB ile uyumlu olmayan BACTEC MGIT 960 sonuçları tekrar çalışılmıştır. İlaçların kritik konsantrasyonlarında her iki sistem arasında %2.25 uyumsuzluk saptanmıştır. Uyumsuz sonuçların tekrar çalışılmasından sonra 2 sistem arasındaki uyumsuzluğun %1.25’e indiği; uyumun %98.75’e yükseldiği gözlenmiştir. Çalışmamızda çok büyük hata saptanmazken; büyük hata oranı 1. çalışmada %2.25 (STR 2, INH 4, RIF 2 ve EMB 1), 2. çalışmada ise %1.25 (INH 3, RIF 2) olarak bulunmuştur. BACTEC MGIT 960 sistemi, BACTEC 460 TB ile karşılaştırıldığında; tüm ilaçlarda özgüllüğün %100, duyarlılığın ise 1. çalışmada %95.6-98.9, 2. çalışmada %96.7-100 oranlarında olduğu saptanmıştır. Sonuç olarak, antitüberküloz duyarlılık test sonuçlarında her iki sistem arasında görülen farklılıkların istatistiksel olarak anlamlı olmadığı, BACTEC MGIT 960 sisteminin, BACTEC 460 TB’nin alternatifi olabileceği kanısına varılmıştır.
The performance of the fully automated BACTEC MGIT 960 (Becton Dickinson, Cockeysville, Md.) system for susceptibility testing of Mycobacterium tuberculosis to critical concentrations of 4 major antituberculosis drugs [streptomycin (STR), isoniazid (INH), rifampin (RIP) and ethambutol (EMB)] was evaluated with 100 clinical isolates and compared to that of the radiometric BACTEC 460 TB (Becton Dickinson, Sparks, Md.) system. The results of BACTEC 960 MGIT, which are not compatible with BACTEC 460 TB, were re-evaluated according to the results obtained. The discordance was 2.25% at the critical concentrations of both systems. After the reproducibility testing, the discordance between 2 systems reduced to 1.25% and the concordance increased to 98.75%. In our study, no very major error was observed; major error was detected as 2.25% (STR 2, INH 4, RIF 2 and EMB 1) in the 1(st) trial, and 1.25% (INH 3, RIF 2) in the 2(nd) trial. When BACTEC 460 TB has been compared with BACTEC 960 MGIT, the overall specificity was 100% in all tests, the sensitivity was 95.6-98.9% in the initial testing, however, the sensitivity changed to 96.7-100% after the reproducibility testing. It was concluded that there was no statistically significant disconcordance between the two test systems. Thus BACTEC MGIT 960 might be an alternative to BACTEC 460 TB for susceptibility testing of antituberculosis agents.
The performance of the fully automated BACTEC MGIT 960 (Becton Dickinson, Cockeysville, Md.) system for susceptibility testing of Mycobacterium tuberculosis to critical concentrations of 4 major antituberculosis drugs [streptomycin (STR), isoniazid (INH), rifampin (RIP) and ethambutol (EMB)] was evaluated with 100 clinical isolates and compared to that of the radiometric BACTEC 460 TB (Becton Dickinson, Sparks, Md.) system. The results of BACTEC 960 MGIT, which are not compatible with BACTEC 460 TB, were re-evaluated according to the results obtained. The discordance was 2.25% at the critical concentrations of both systems. After the reproducibility testing, the discordance between 2 systems reduced to 1.25% and the concordance increased to 98.75%. In our study, no very major error was observed; major error was detected as 2.25% (STR 2, INH 4, RIF 2 and EMB 1) in the 1(st) trial, and 1.25% (INH 3, RIF 2) in the 2(nd) trial. When BACTEC 460 TB has been compared with BACTEC 960 MGIT, the overall specificity was 100% in all tests, the sensitivity was 95.6-98.9% in the initial testing, however, the sensitivity changed to 96.7-100% after the reproducibility testing. It was concluded that there was no statistically significant disconcordance between the two test systems. Thus BACTEC MGIT 960 might be an alternative to BACTEC 460 TB for susceptibility testing of antituberculosis agents.
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Keywords
Antituberculosis drugs, Major error, Mycobacterium tuberculosis, Very major error, Growth indicator tube, Multicenter evaluation, 1st-line, Rifampin, Microbiology, Mycobacterium tuberculosis, Antitüberküloz ilaçlar, Büyük hata, Çok büyük hata
Citation
Sınırtaş, M. vd. (2009). "Mikobakterilerin majör antitüberküloz ilaçlara duyarlılıǧının otomatize bactec MGIT 960 sistemi ile araştırılması ve radyometrik bactec 460 TB sistemi ile karşılaştırılması". Mikrobiyoloji Bülteni, 43(3), 403-409.