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.

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 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

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

A Preliminary Study on the Synergistic Effect of Nano Ag and Anti-Tuberculosis Drugs on Drug-Resistant Mycobacterium tuberculosis

2020 ◽  
Vol 20 (10) ◽  
pp. 6155-6160
Author(s):  
Xiaofei Li ◽  
Lina Sheng ◽  
Juncai Tu ◽  
Lianqing Lou
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Drug Sensitivity ◽  
Bactericidal Effect ◽  
Clinical Isolates ◽  
Drug Resistant ◽  
Tubercle Bacillus ◽  
Drug Resistant Tuberculosis ◽  
Nano Silver ◽  
Resistant Tuberculosis ◽  
Drug Sensitivity Test

To determine the bactericidal effect of nano silver and anti-tuberculosis drugs on drug-resistant Mycobacterium tuberculosis. Solid-state drug sensitivity tests with streptomycin (SM), isoniazid (INH), RIF, EMB, kanamycin (km), and ofloxacin (ofx) were carried out on H37Rv and different clinical isolates. Briefly, the effects of SM, INH, RIF, EMB (1.0 μg/mL, 0.1 μg/mL, 1.0 μg/mL, 5.0 μg/mL), and anti-tuberculosis drugs, and their combined effect with 0.15 μg/mL and 0.30 μg/mL nano silver on drug-resistant tuberculosis bacteria were evaluated by liquid drug sensitivity test. At the low concentration (0.15 μg/mL), nano silver could not effectively kill the tuberculosis strains; however, at concentrations ≥0.30 μg/mL, it could effectively kill H37Rv and the clinical isolates of the sensitive, single-resistant, multi-resistant, multi-resistant, and extensively resistant strains. Combining 0.15 μg/mL nano silver with the four first-line anti-tuberculosis drugs could not effectively kill the tuberculosis strains; however, combining 0.30 μg/mL nano silver and the anti-tuberculosis drugs could effectively kill the drug-resistant tuberculosis strains. Nano silver exhibits a concentrationdependent killing effect on tubercle bacillus. Further, a nano silver concentration higher than 0.30 μg/mL could kill sensitive and resistant tubercle bacillus.

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