scholarly journals Evaluation of Nitrate Reductase Assay For Rapid Detection of Drug Resistant Tuberculosis

2019 ◽  
Vol 3 (1) ◽  
pp. 44-46
Author(s):  
Ranjit Kumar Sah ◽  
Dwij Raj Bhatta ◽  
Gokarna Raj Ghimire ◽  
Bhuwaneswor Prasad Kandel ◽  
Bishnu Raj Tiwari ◽  
...  
Keyword(s):  
Nitrate Reductase ◽  
Sensitivity And Specificity ◽  
Susceptibility Testing ◽  
Reference Laboratory ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Nitrate Reductase Assay ◽  
Mdr Tb ◽  
Proportion Method

Emergence of multidrug-resistant tuberculosis (MDR-TB) urgently demands for simple, rapid and inexpensive methods of its detection for the effective treatment of drug resistant tuberculosis, particularly in low-income countries. This prospective study was carried out at National Tuberculosis Reference Laboratory and South Asian Association of Regional Cooperation (SAARC) Tuberculosis and HIV/AIDS Centre, Thimi, Bhaktapur, Nepal, from November 2009 to May 2010 to evaluate nitrate reductase assay (NRA) efficacy for rapid determination of streptomycin, isoniazid, rifampicin and ethambutol susceptibility of Mycobacterium tuberculosis strains. A total of 113 clinical isolates of M. tuberculosis were tested for four first line antitubercular drugs by nitrate reductase assay and were compared with standard proportion method. Results were available in 7-14 days by NRA as compared to proportion method which generally takes 4-6 weeks. The sensitivity and specificity of NRA were 98.1% and 100% for isoniazid, 95.1% and 98.6% for rifampicin, 91.4% and 94.9% for streptomycin, and 78.6% and 97.9% for ethambutol respectively. Agreement between NRA and proportion method were 99.1%, 97.3%, 93.8%, 95.6% for isoniazid, rifampicin, streptomycin and ethambutol, respectively. NRA is easier, inexpensive and reliable method for susceptibility testing of Mycobacterum tuberculosis for isoniazid and rifampicin, the two most important drugs for the treatment of tuberculosis. The reduction in susceptibility testing time, and higher sensitivity and specificity of NRA method is of fundamental importance in detecting MDR-TB. Key words: Drug susceptibility, MDR-TB, NRA, proportion method

scholarly journals Evaluation of Nitrate Reductase Assay for Rapid Detection of Drug Resistant Tuberculosis

2013 ◽  
Vol 9 (2) ◽  
pp. 4-8
Author(s):  
Ranjit Kumar Sah ◽  
DR Bhatta ◽  
GR Ghimire ◽  
BP Kandel ◽  
BR Tiwari ◽  
...  
Keyword(s):  
Nitrate Reductase ◽  
Sensitivity And Specificity ◽  
Susceptibility Testing ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Nitrate Reductase Assay ◽  
Mdr Tb ◽  
Proportion Method ◽  
Hiv Aids

Introduction: Emergence of multidrug-resistant tuberculosis (MDR-TB) urgently demands for simple,  rapid and inexpensive methods of its detection for the effective treatment of drug resistant tuberculosis,  particularly in low-income countries. Methodology: This prospective study was carried out at National Tuberculosis Reference Laboratory  and South Asian Association of Regional Cooperation (SAARC) Tuberculosis and HIV/AIDS Centre,  Thimi, Bhaktapur, Nepal, from November 2009 to May 2010 to evaluate nitrate reductase assay (NRA)  efficacy for rapid determination of streptomycin, isoniazid, rifampicin and ethambutol susceptibility of  Mycobacterium tuberculosis strains. Results: A total of 113 clinical isolates of M. tuberculosis were tested for four first line antitubercular drugs  by nitrate reductase assay and were compared with standard proportion method. Results were available  in 7-14 days by NRA as compared to proportion method which generally takes 4-6 weeks. The sensitivity  and specificity of NRA were 98.1% and 100% for isoniazid, 95.1% and 98.6% for rifampicin, 91.4% and  94.9% for streptomycin, and 78.6% and 97.9% for ethambutol, respectively. Agreement between NRA  and proportion method were 99.1%, 97.3%, 93.8%, 95.6% for isoniazid, rifampicin, streptomycin and  ethambutol, respectively. Conclusion: NRA is easier, inexpensive and reliable method for susceptibility testing of Mycobacterum  tuberculosis for isoniazid and rifampicin, the two most important drugs for the treatment of tuberculosis.  The reduction in susceptibility testing time, and higher sensitivity and specificity of NRA method is of  fundamental importance in detecting MDR-TB. SAARC Journal of Tuberculosis, Lung Diseases & HIV/AIDS; 2012; IX(2) 5-8 DOI: http://dx.doi.org/10.3126/saarctb.v9i2.7971

scholarly journals Evaluation of Nitrate Reductase Assay (NRA) for rapid detection of druc resistant tuberculosis at National Tuberculosis Centre, Nepal

1970 ◽  
Vol 7 (1) ◽  
pp. 26-30
Author(s):  
PK Mandal ◽  
S Basnyat ◽  
DK Khadka ◽  
DR Bhatta
Keyword(s):  
Drug Resistance ◽  
Nitrate Reductase ◽  
Sensitivity And Specificity ◽  
Drug Susceptibility ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
National Tuberculosis ◽  
Nitrate Reductase Assay ◽  
Hiv Aids

Background: Treatment of drug-resistant tuberculosis is often based on drug susceptibility testing results. Thus simple, rapid and economic test is very important for diagnosis of drug resistant tuberculosis and such method aids in TB control effectively. One such method is a Nitrate Reductase Assay (NRA). Objective: To evaluate feasibility and performance of Nitrate Reductase Assay in the screening of drug-resistant tuberculosis. Setting: National Tuberculosis Centre and SAARC TB and HIV/AIDS Centre, Thimi, Bhaktapur, Nepal from April 2008 to March 2009. Methods: A prospective study comparing the sensitivity and specificity of the Nitrate Reductase Assay with the gold standard Lowenstein Jensen proportion method in determining drug susceptibility pattern to four primary anti-tubercular drugs i.e. isoniazid, rifampicin, streptomycin and ethambutal among clinical isolates.Results: Among 121 specimens , the sensitivity and specificity of the Nitrate Reductase Assay for detection of Isoniazid resistance was 100% and 91%, for rifampicin was 100% and 98.95%, for streptomycin was 96% and 91.66% and for ethambutal was 100% and 98% respectively.Conclusions: The Nitrate Reductase Assay is sensitive and specific enough for the detection of drug resistant tuberculosis. It is rapid, easy to use and inexpensive, making it suitable for developing countries. Its usefulness for national drug resistance surveys should be assessed. Keywords: diagnosis; drug resistance; sensitivity; specificity; NRADOI: 10.3126/saarctb.v7i1.3960SAARC J. TUBER. LUNG DIS. HIV/AIDS 2010 VII(1) 26-30

scholarly journals Socio-demographic Profile and Drug Sensitivity Pattern of Suspected Drug Resistant Tuberculosis among Patients in Regional Tuberculosis Reference Laboratory (R.T.R.L) of a Tertiary Hospital

2017 ◽  
Vol 18 (2) ◽  
pp. 62-67 ◽  
Author(s):  
Ummay Fatema Khatun ◽  
Robed Amin ◽  
Muna Islam ◽  
Abdur Rob ◽  
Abdur Rahim
Keyword(s):  
Drug Resistance ◽  
Drug Sensitivity ◽  
Reference Laboratory ◽  
Drug Resistant ◽  
Suspected Drug ◽  
Drug Resistant Tuberculosis ◽  
Demographic Profile ◽  
Resistant Tuberculosis ◽  
Sensitivity Pattern ◽  
Mdr Tb

Background: Drug resistant tuberculosis has been reported in all regions of the world. In this study we address the socio-demographic profile and drug sensitivity pattern as well as prevalence of drug resistance tuberculosis in a tertiary center (regional TB reference laboratory) in Bangladesh.Method: This Study was carried out in R.T.R.L. (Regional TB Reference Laboratory) in 250 bedded Chittagong General Hospital. Patients who were referred to R.T.R.L during the period July 2012 to July 2013 were included in the study. Total 100 patients with suspected drug resistant tuberculosis (TB) who had any one of 9 criteria of NTP (National Tuberculosis Control Programme) were selected consecutively. Gene xpert MTB/RIF (Rifampicin resistance) test for all sputum positive cases were performed. Sputum sample of Patients with positive microscopy for AFB or positive Xpert/MTB was sent for culture. The samples with positive sputum culture were sent for drug sensitivity test for 1st line anti- tubercular drug.Result: Among 100 patients 78 were male and 22 were female, majority of the patients (64) were between 15-45 years with poor socio economic condition (73%) and primarily educated. Analysis of our Study result showed that 18% of patients were mono-drug resistant. Among them 13% showed resistance to isoniazid (INH), 4% to streptomycin and only 2% to rifampicin. No patient was found resistant to pyrazinamide (PNZ) and 38% of patient with suspected drug – resistant TB was found to have no drug resistance. 18% of patient had multidrug resistant tuberculosis (MDR-TB) among which 56% were relapse cases (48% after cat -I, 8% after cat II), 24% were non – converter of cat –I, 12% belonged to failure of cat –I, 3% failure of cat –II, 2% return after default and others. 1% of patient had history of contact with MDR –TB patient.Conclusion: Drug-resistance tuberculosis especially MDR-TB, was higher in patients with previously incomplete anti-tuberculosis treatment. A high level of drug resistance among the re-treatment TB patients poses a threat of transmission of resistant strains to susceptible persons in the community. For this reason proper counseling of patients and attention towards the completion of the anti-TB treatment are needed.J MEDICINE July 2017; 18 (2) : 62-67

scholarly journals Evaluation of Nitrate Reductase Assay for Rapid Detection of Drug Resistant Tuberculosis

2012 ◽  
Vol 02 (04) ◽  
pp. 138-141
Author(s):  
Ranjit Kumar Sah ◽  
Dwij Raj Bhatta ◽  
Gokarna Raj Ghimire ◽  
Jeevan Bahadur Sherchand
Keyword(s):  
Nitrate Reductase ◽  
Rapid Detection ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Nitrate Reductase Assay

PD64 Diagnostic Accuracy Of The Nitrate Reductase Assay Technique

2018 ◽  
Vol 34 (S1) ◽  
pp. 153-153
Author(s):  
Dalila Gomes ◽  
Betânia Leite ◽  
Fabiana Araujo Figueiredo da Mata
Keyword(s):  
Nitrate Reductase ◽  
Drug Sensitivity ◽  
Sensitivity Test ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Drug Sensitivity Test ◽  
Conventional Drug ◽  
Time To Diagnosis ◽  
Nitrate Reductase Assay

Introduction:The conventional drug sensitivity test is traditionally used in Brazil to diagnose drug-resistant tuberculosis. However, the test can take up to 60 days to return a diagnosis, which is considered too long for certain vulnerable populations. Therefore, this study analyzed the available scientific evidence on the accuracy and time to diagnosis of the nitrate reductase assay for diagnosing resistant tuberculosis, compared with the conventional drug sensitivity test.Methods:We searched MEDLINE, Embase, and The Cochrane Library for systematic reviews with meta-analyses. The articles were screened by title and abstract. The full-texts of potentially relevant articles were then screened according to the inclusion criteria.Results:Three systematic reviews with meta-analyses were selected that compared the nitrate reductase assay with the conventional drug sensitivity test. The accuracy of the nitrate reductase assay was satisfactory in most of the results when compared with the sensitivity test, except for one study that showed low sensitivity for the detection of streptomycin resistance. In addition, the nitrate reductase assay had a shorter time to diagnosis than the drug sensitivity test.Conclusions:The results of this study reinforce the idea that the nitrate reductase assay may diagnose drug-resistant tuberculosis earlier than the conventional drug sensitivity test and be a helpful strategy for controlling the disease, especially in vulnerable populations that are more likely to be affected by tuberculosis. For a broader analysis of the benefit of the assay, it is suggested that studies investigate the impact of the shorter time to diagnosis on morbidity and mortality in patients with drug-resistant tuberculosis. In addition, economic analyses comparing the nitrate reductase assay with the sensitivity test are recommended to evaluate the cost-benefit ratio.

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