What is resistance? Impact of phenotypic versus molecular drug resistance testing on therapy for multi-and extensively drug-resistant tuberculosis
byJan Heyckendorf, Sönke Andres, Claudio U Köser, Ioana D Olaru, Thomas
Schön, Erik Sturegård, Patrick Beckert, Viola Schleusener, Thomas A
Kohl, Doris Hillemann, Danesh Moradigaravand, et al.
Research ArticleYear:2018
Extra Information
Antimicrobial agents and chemotherapy, 62(2) e01550-17
Abstract
Rapid and accurate drug susceptibility testing (DST) is essential for
the treatment of multi- and extensively drug-resistant tuberculosis
(M/XDR-TB). We compared the utility of genotypic DST assays with
phenotypic DST (pDST) using Bactec 960 MGIT or Löwenstein-Jensen to
construct M/XDR-TB treatment regimens for a cohort of 25 consecutive
M/XDR-TB patients and 15 possible anti-TB drugs. Genotypic DST results
from Cepheid GeneXpert MTB/RIF (Xpert) and line probe assays (LPAs; Hain
GenoType MTBDRplus 2.0 and MTBDRsl 2.0) and whole-genome
sequencing (WGS) were translated into individual algorithm-derived
treatment regimens for each patient. We further analyzed if
discrepancies between the various methods were due to flaws in the
genotypic or phenotypic test using MIC results. Compared with pDST, the
average agreement in the number of drugs prescribed in genotypic
regimens ranged …