Resazurin Assay for Drug Susceptibility Testing in TB Sputum Samples

| Posted in: Science Health Sciences

Journal name: The Malaysian Journal of Medical Sciences
Original article title: Direct Resazurin Microplate Assay in Drug Susceptibility Testing of Smear-Positive Sputum Samples against Mycobacterium tuberculosis
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

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Author:

Noor Izani Noor Jamil, Wan Nor Amilah Wan Abdul Wahab, Ibyhaslin Alyani Ali, Mohammad Lukman Yahaya


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Direct Resazurin Microplate Assay in Drug Susceptibility Testing of Smear-Positive Sputum Samples against Mycobacterium tuberculosis

Year: 2018 | Doi: 10.21315/mjms2018.25.6.6

Copyright (license): CC BY 4.0


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Summary of article contents:

Introduction

Tuberculosis (TB) remains a significant global health challenge, affecting millions in both developed and developing countries. Despite progress in reducing TB deaths, the emergence of multi-drug resistant strains poses a major obstacle to treatment efforts. Various conventional methods for drug susceptibility testing (DST) are time-consuming and often require prior isolation of Mycobacterium tuberculosis, which delays diagnosis. This study evaluates a direct microplate-based colorimetric drug susceptibility test that eliminates the need for initial isolation from clinical specimens, thereby potentially shortening the turnaround time (TAT) for results.

Direct Resazurin Microplate Assay (REMA)

The study focused on the Resazurin Microplate Assay (REMA) as a rapid method for testing the susceptibility of M. tuberculosis to key first-line antibiotics, isoniazid (INH) and rifampicin (RIF). A total of 51 smear-positive sputum samples were analyzed, and the REMA method demonstrated a sensitivity of 90%, specificity of 100%, and an overall accuracy of 97% compared to the established absolute concentration method (ACM). The average TAT for obtaining susceptibility results through REMA was 15 days, significantly faster than the 3-6 weeks required by conventional methods. The high predictive values for both resistant (PVR) and susceptible (PVS) strains further support the reliability of REMA in routine diagnostic laboratories.

Conclusion

The findings suggest that the direct REMA offers a viable alternative for the rapid detection of drug susceptibility in M. tuberculosis, particularly for identifying multi-drug-resistant strains. By streamlining the testing process and significantly reducing turnaround times, this method could enhance TB management efforts, especially in regions with limited resources. The study underscores the importance of developing reliable and efficient diagnostic tools to combat the growing threat of drug-resistant tuberculosis on a global scale.

FAQ section (important questions/answers):

What is the purpose of the direct REMA method?

The direct REMA method aims to provide rapid drug susceptibility testing for Mycobacterium tuberculosis directly from sputum samples, bypassing the need for initial isolation, ultimately shortening the turnaround time for results.

What drugs were tested for susceptibility using REMA?

The study evaluated the susceptibility of Mycobacterium tuberculosis to isoniazid (INH) and rifampicin (RIF) using the resazurin microplate assay (REMA) method, comparing the results with the gold standard, absolute concentration method (ACM).

How effective was the direct REMA method's performance?

The direct REMA method exhibited strong performance, with 90% sensitivity, 100% specificity, and a 15-day turnaround time. It accurately identified resistant isolates for both INH and RIF, demonstrating reliability for routine diagnostics.

What are the implications of using direct REMA in laboratories?

Implementing direct REMA in diagnostic laboratories could significantly enhance the speed and accuracy of drug susceptibility testing for tuberculosis, especially in resource-limited settings, aiding in the timely treatment of affected patients.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Resazurin Assay for Drug Susceptibility Testing in TB Sputum Samples”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Tuberculosis:
Tuberculosis (TB) is a contagious bacterial infection primarily affecting the lungs but can also impact other parts of the body. It poses significant public health challenges worldwide, especially in developing countries. Understanding TB is crucial for effective detection, treatment, and epidemiological studies, given its high mortality rates and drug resistance issues.

2) Drug:
Drugs are substances used to prevent, diagnose, treat, or cure diseases. In the context of tuberculosis, specific drug therapies such as Isoniazid and Rifampicin are critical in managing TB. The effectiveness, resistance patterns, and susceptibility testing to these drugs are vital for successful TB treatment regimens.

3) Table:
Tables are organized data sets that present results or findings succinctly. In research, tables serve to compare varying results, such as minimum inhibitory concentrations (MIC) of drugs in different assays. They facilitate quick reference and understanding of complex data, making it easier to analyze and interpret results.

4) Study (Studying):
A study is an investigation aimed at acquiring knowledge or understanding of a subject. In the context of TB, studies often focus on the efficacy of diagnostic methods, treatment regimens, and resistance patterns. Rigorous studies contribute to the advancement of medical practices and improve patient care strategies in TB management.

5) Line:
In the context of tuberculosis treatment, 'first-line' refers to the primary medications used to treat the disease effectively. These drugs are essential for initial therapy and are the standard against which new treatment options are compared. Understanding the efficacy and resistance of first-line drugs is critical to TB control strategies.

6) Performance:
Performance in a scientific context refers to the effectiveness and efficiency of a diagnostic or treatment method. It encompasses attributes like accuracy, sensitivity, and specificity. Evaluating the performance of tests, like the direct resazurin microplate assay, is crucial in determining their reliability and usefulness in clinical settings for TB management.

7) Observation:
Observation refers to the systematic watch and analysis of phenomena, often leading to conclusions. In scientific research, careful observation of experiments and outcomes is crucial. Observational data, such as color changes in assays, help in understanding the effectiveness of TB treatment and contribute to improving testing methodologies.

8) Antibiotic (Antibacterial):
Antibiotics are a class of drugs that fight bacterial infections by inhibiting growth or killing bacteria. In the context of tuberculosis, antibiotics like Isoniazid and Rifampicin are critical in treatment. The challenge of antibiotic resistance highlights the importance of testing for susceptibility to ensure effective therapy for TB patients.

9) Disease:
A disease is a pathological condition of a bodily part that manifests symptoms and signs. Tuberculosis is a prevalent infectious disease caused by Mycobacterium tuberculosis. Understanding the pathophysiology and epidemiology of TB is vital for public health measures, prevention strategies, and the development of effective therapeutics.

10) Science (Scientific):
Science is a systematic enterprise that builds and organizes knowledge through observation, experimentation, and validation. In medical research, science guides the development of diagnostic tests, treatment protocols, and understanding of diseases. The scientific method is essential for validating findings related to tuberculosis and improving healthcare outcomes.

11) Medium:
In microbiology, 'medium' refers to the substrate or materials used to cultivate microorganisms. For tuberculosis testing, specialized media like Middlebrook 7H9 broth are employed to grow Mycobacterium tuberculosis. The choice of medium significantly affects the accuracy and speed of drug susceptibility testing in clinical laboratories.

12) Rules:
Rules in scientific research refer to established protocols or guidelines that govern methodologies and interpretations. Adherence to these rules ensures reliability and consistency in research findings. In TB studies, rules dictate how susceptibility tests are performed, reported, and validated, contributing to the integrity of health interventions.

13) Death:
Death is the cessation of all biological functions that sustain a living organism. In the context of tuberculosis, mortality rates remain high, underscoring the disease's severity. Understanding factors contributing to TB-related deaths is essential for improving management strategies, preventive measures, and ultimately reducing the disease's impact on public health.

14) Activity:
In this context, activity refers to the effectiveness of a substance, specifically antibiotics, in inhibiting or destroying bacteria. For tuberculosis treatment, understanding the activity of different drugs against Mycobacterium tuberculosis is crucial for developing effective therapies and combating multi-drug-resistant strains.

15) Kumar:
Kumar is a common surname and may refer to an author or researcher involved in a study related to tuberculosis. Individual contributions in research collaborations often enhance the breadth and depth of scientific inquiry, aiding our understanding of diseases and leading to advancements in public health.

16) Pavan:
Pavan likely refers to a contributor or researcher in the context of tuberculosis studies. Authors contribute unique insights to scientific discourse, leading to collective advancements in understanding disease mechanisms, treatment efficacy, and improving predictive models for public health interventions.

17) Raja:
Raja is a name that may refer to one of the researchers or professionals involved in tuberculosis studies. Individuals like Raja contribute to the collaboration of research projects, which is crucial for sharing knowledge, resources, and methodologies necessary for tackling complex public health challenges such as TB.

18) Siti (Shiti):
Siti is a common name and may represent a researcher or study author in tuberculosis research. Each researcher’s role is essential in advancing scientific knowledge, fostering collaborative efforts that lead to innovative solutions for health challenges, including effective TB treatment and management.

19) Sah:
Shah likely refers to an author or researcher involved in tuberculosis research. Names in research typically represent individuals who significantly influence the direction of studies. Their findings contribute to the broader understanding of drug resistance and effective treatment strategies for TB.

20) Gold (Golden):
In scientific research, particularly in medicine, 'gold standard' refers to the best or most reliable method against which others are compared. The absolute concentration method for measuring drug susceptibility in tuberculosis can be considered a gold standard, providing valuable benchmarks for evaluating new testing methods.

21) Reliability:
Reliability in scientific studies refers to the consistency of a measurement or method over time. In the context of TB susceptibility testing, establishing reliability ensures that results can be replicated and trusted by clinicians, thereby enhancing patient management and treatment outcomes.

22) Discussion:
The discussion section of a research paper interprets findings and situates them within the broader context of existing knowledge. This critical analysis helps to clarify implications for practice, policy, and future research, particularly in understanding complex diseases like tuberculosis and associated treatment methodologies.

23) Developing:
Developing often refers to low- and middle-income countries where tuberculosis is endemic. Efforts to improve disease management, accessibility to treatments, and public health infrastructure in these regions are crucial in combating TB and improving health outcomes for the populations affected.

24) Similarity:
Similarity in research indicates the degree of resemblance between different studies or findings. Identifying similarities across studies helps validate methods, ensures robustness in results, and encourages the adoption of successful strategies in tackling public health issues, such as tuberculosis treatment protocols.

25) Reason:
Reasoning in scientific research is a logical process that connects hypotheses, methods, and conclusions. Understanding the reasons behind particular study designs or results is crucial for building credible scientific narratives. In tuberculosis research, reasoning helps explain observed drug susceptibility patterns among Mycobacterium tuberculosis strains.

26) Glass:
Glass refers to the material commonly used for laboratory equipment, such as test tubes and petri dishes. In microbiology, glassware is essential for culturing and observing bacterial growth. Proper handling and use of glassware ensure integrity and accuracy in laboratory experiments related to tuberculosis and other pathogens.

27) Post:
In the research context, 'post' may refer to follow-up studies or the results communicated after completing a study. Post-publication discussions and analyses can provide insights and critiques of research findings, enhancing the collective understanding of treatment effectiveness, especially in diseases like tuberculosis.

Other Health Sciences Concepts:

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Discover the significance of concepts within the article: ‘Resazurin Assay for Drug Susceptibility Testing in TB Sputum Samples’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

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