Evaluation of the Performance of Nitrate Reductase Assay for Rapid Drug-susceptibility Testing of Mycobacterium tuberculosis in North India.
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Date
2011-02
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Abstract
The objective of the study was to evaluate the performance of nitrate reductase assay (NRA) as a rapid, reliable
and inexpensive method for drug-susceptibility testing (DST) of Mycobacterium tuberculosis against firstline
antitubercular drugs, such as rifampicin (RIF), isoniazid (INH), streptomycin (STR), and ethambutol
(EMB). In total, 286 isolates were subjected to test by proportion method (PM) and NRA. By comparing the
results of NRA with those of the gold standard PM, sensitivities and specificities were 98.4%, 97%, 88.5%,
and 94.2% and 100%, 100%, 94%, and 99% for RIF, INH, STR, and EMB respectively. The positive predictive
values were 100%, 100%, 95%, and 98% for RIF, INH, STR, and EMB respectively. The negative values
were 99%, 98%, 87%, and 96% for RIF, INH, STR, and EMB respectively. The median time of obtaining
results was shorter using NRA (10 days) compared to PM (28 days). An excellent agreement was observed
between the two phenotypic tests with the κ values of 0.98, 0.97, 0.81, and 0.93 for RIF, INH, STR, and
EMB respectively. The results demonstrated that NRA is suitable for the early determination of INH and
RIF resistance and has the potential to be a useful tool for rapid drug-sensitivity test of M. tuberculosis in
resource-constrained settings.
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Keywords
Antitubercular agents, Mycobacterium tuberculosis, Drug resistance, Mutiple, Nitrate reductase assay, Tuberculosis, Multi-drug-resistant, India
Citation
Gupta Anamika, Sen Malay Ranjan, Mohapatra Tribhuban Mohan, Anupurba Shampa. Evaluation of the Performance of Nitrate Reductase Assay for Rapid Drug-susceptibility Testing of Mycobacterium tuberculosis in North India. Journal of Health, Population and Nutrition. 2011 Feb; 29(1): 20-25.