{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:28:59Z","timestamp":1777922939627,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T00:00:00Z","timestamp":1561939200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>\n                      Extensively drug-resistant tuberculosis (XDRTB) is a public health concern. We evaluated the diagnostic accuracy of Genotype\n                      <jats:sup>\u00ae<\/jats:sup>\n                      MTBDRsl for detection of resistance to fluoroquinolones (FQs) and second-line injectable drugs (SLIDs) and characterized mutations seen.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      MTBDRsl was carried out either directly on sputum samples or indirectly on culture isolates (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009100) from known multidrug-resistant tuberculosis (MDRTB) patients from July 2015 to September 2017. Diagnostic accuracy for the detection of resistance to FQs and SLIDs was calculated in comparison with conventional culture-based drug susceptibility testing. Mutations at the\n                      <jats:italic toggle=\"yes\">gyrA<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">rrs<\/jats:italic>\n                      loci, as well as discrepant phenotypic and genotypic results, were studied. A subset of isolates underwent pyrosequencing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Out of 100 MDRTB samples\/isolates tested, 59% were pre-XDRTB and 7% were XDRTB. The sensitivity and specificity for the detection of resistance to FQs were 96.6% [95% confidence interval (CI): 88.3\u201399.6] and 80% [95% CI: 64.4\u201390.9] and those for SLIDs were 70% [95% CI: 34.8\u201393.3] and 100% [95% CI: 95.9\u2013100]. The most frequent mutations were the absence of wild type 3 with corresponding mutation 3c (20\/66) at the\n                      <jats:italic toggle=\"yes\">gyrA<\/jats:italic>\n                      locus, and absence of wild type 1 and corresponding mutation 1 (6\/7) at the\n                      <jats:italic toggle=\"yes\">rrs<\/jats:italic>\n                      locus. The absence of a wt2 band with a corresponding mutation at the\n                      <jats:italic toggle=\"yes\">gyrA<\/jats:italic>\n                      locus was seen in four of eight patients with discrepant genotypic and phenotypic results for FQ resistance. All isolates tested by pyrosequencing (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20095) were concordant with the line probe assay for FQ resistance with identical mutations (D94G) and four of five isolates were concordant with SLIDs with identical mutations (A1401G).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The MTBDRsl is a useful test for accurate diagnosis of XDRTB and may help to tailor therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/mdr.2018.0268","type":"journal-article","created":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T15:29:01Z","timestamp":1550676541000},"page":"799-804","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Robustness of the Line Probe Assay for the Rapid Diagnosis and Characterization of Mutations in Extensively Drug-Resistant Tuberculosis"],"prefix":"10.1177","volume":"25","author":[{"given":"Marilyn M.","family":"Ninan","sequence":"first","affiliation":[{"name":"Department of Microbiology, CMC, Vellore, Tamil Nadu, India."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priscilla","family":"Rupali","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, CMC, Vellore, Tamil Nadu, India."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prince","family":"James","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, CMC, Vellore, Tamil Nadu, India."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joy S.","family":"Michael","sequence":"additional","affiliation":[{"name":"Department of Microbiology, CMC, Vellore, Tamil Nadu, India."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,7,11]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"WHO Global Tuberculosis Report. 2017. [cited 2018 Mar 28]. Available at http:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/259366\/9789241565516-eng.pdf;jsessionid=FAEAB11EC5642BB6E765E2E139B3459B?sequence=1"},{"key":"e_1_3_2_3_2","unstructured":"The Global Plan to Stop TB. 2016\u20132020. [cited 2018 Mar 28]. Available at www.stoptb.org\/assets\/documents\/global\/plan\/GlobalPlanToEndTB_TheParadigmShift_2016\u20132020_StopTBPartnership.pdf"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1055\/s-0028-1085707","article-title":"New diagnostics for latent and active tuberculosis: state of the art and future prospects","volume":"29","author":"Pai M.","year":"2008","unstructured":"Pai M., , and O'Brien R.. 2008. New diagnostics for latent and active tuberculosis: state of the art and future prospects. Semin. Respir. Crit. Care Med. 29:560\u2013568.","journal-title":"Semin. Respir. Crit. Care Med"},{"key":"e_1_3_2_5_2","unstructured":"The use of molecular line probe assays for the detection of resistance to second-line anti-tuberculosis drugs\u2014WHO 2016 Policy guidance. [cited 2017 Jun 21]. Available at http:\/\/apps.who.int\/iris\/bitstream\/10665\/246131\/1\/9789241510561-eng.pdf?ua=1"},{"key":"e_1_3_2_6_2","unstructured":"The use of molecular line probe assay for the detection of resistance to second line anti tuberculosis drugs WHO policy guidance. 2013. [cited 2018 May 2]. Available at http:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/78099\/WHO_HTM_TB_2013.01.eng.pdf;jsessionid=2964284F8C7EB2042B9E9A8D65A0BB0C?sequence=1"},{"key":"e_1_3_2_7_2","doi-asserted-by":"crossref","first-page":"24","DOI":"10.5588\/ijtld.15.0221","article-title":"Clinical implications of molecular drug resistance testing for Mycobacterium tuberculosis: a TBNET\/RESIST-TB consensus statement","volume":"20","author":"Dom\u00ednguez J.","year":"2016","unstructured":"Dom\u00ednguez J., , Boettger E.C., , Cirillo D., , Cobelens F., , Eisenach K.D., , Gagneux S., , Hillemann D., , Horsburgh R., , Molina-Moya B., , Niemann S., , Tortoli E., , Whitelaw A., , and Lange; TBNET; RESIST-TB networks C.. 2016. Clinical implications of molecular drug resistance testing for Mycobacterium tuberculosis: a TBNET\/RESIST-TB consensus statement. Int. J. Tuberc. Lung. Dis. Off. J. Int. Union. Tuberc. Lung. Dis. 20:24\u201342.","journal-title":"Int. J. Tuberc. Lung. Dis. Off. J. Int. Union. Tuberc. Lung. Dis"},{"key":"e_1_3_2_8_2","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1093\/jac\/dkv360","article-title":"Specific gyrA gene mutations predict poor treatment outcome in MDR-TB","volume":"71","author":"Rigouts L.","year":"2016","unstructured":"Rigouts L., , Coeck N., , Gumusboga M., , de Rijk W.B., , Aung K.J.M., , Hossain M.A., , Fissette K., , Rieder H.L., , Meehan C.J., , de Jong B.C., , and Van Deun A.. 2016. Specific gyrA gene mutations predict poor treatment outcome in MDR-TB. J. Antimicrob. Chemother. 71:314\u2013323.","journal-title":"J. Antimicrob. 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PLoS One. 9:e95083.","journal-title":"PLoS One"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00398-14"},{"key":"e_1_3_2_22_2","doi-asserted-by":"crossref","first-page":"e02169","DOI":"10.1128\/AAC.02169-16","article-title":"Some synonymous and nonsynonymous gyrA mutations in Mycobacterium tuberculosis lead to systematic false-positive fluoroquinolone resistance results with the hain GenoType MTBDRsl assays","volume":"61","author":"Ajileye A.","year":"2017","unstructured":"Ajileye A., , Alvarez N., , Merker M., , Walker T.M., , Akter S., , Brown K., , Moradigaravand D., , Sch\u00f6n T., , Andres S., , Schleusener V., , Omar S.V, , Coll F., , Huang H., , Diel R., , Ismail N., , Parkhill J., , de Jong B.C., , Peto T.E., , Crook D.W., , Niemann S., , Robledo J., , Smith E.G., , Peacock S.J., , and K\u00f6ser C.U.. 2017. Some synonymous and nonsynonymous gyrA mutations in Mycobacterium tuberculosis lead to systematic false-positive fluoroquinolone resistance results with the hain GenoType MTBDRsl assays. Antimicrob. Agents Chemother. 61:e02169\u201316.","journal-title":"Antimicrob. Agents Chemother"},{"key":"e_1_3_2_23_2","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1128\/JCM.02505-15","article-title":"MTBDRplus and MTBDRsl assays: absence of wild-type probe hybridization and implications for detection of drug-resistant tuberculosis","volume":"54","author":"Seifert M.","year":"2016","unstructured":"Seifert M., , Georghiou S.B., , Catanzaro D., , Rodrigues C., , Crudu V., , Victor T.C., , Garfein S., , Catanzaro A., , and Rodwell T.C.. 2016. MTBDRplus and MTBDRsl assays: absence of wild-type probe hybridization and implications for detection of drug-resistant tuberculosis. J. Clin. Microbiol. 54:912\u2013918.","journal-title":"J. Clin. 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Disparities in capreomycin resistance levels associated with the rrs A1401G mutation in clinical isolates of Mycobacterium tuberculosis. Antimicrob. Agents Chemother. 59:444\u2013449.","journal-title":"Antimicrob. Agents Chemother"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12875"},{"key":"e_1_3_2_27_2","doi-asserted-by":"crossref","first-page":"233","DOI":"10.5588\/ijtld.13.0468","article-title":"Performance of the MTBDRsl assay in Georgia","volume":"18","author":"Tukvadze N.","year":"2014","unstructured":"Tukvadze N., , Bablishvili N., , Apsindzelashvili R., , Blumberg H.M., , and Kempker R.R.. 2014. Performance of the MTBDRsl assay in Georgia. Int. J. Tuberc. Lung Dis. 18:233\u2013239.","journal-title":"Int. J. Tuberc. 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Cochrane Database Syst Rev. 10:CD010705.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_31_2","doi-asserted-by":"crossref","first-page":"2026","DOI":"10.1128\/JCM.06664-11","article-title":"Detection of first- and second-line drug resistance in Mycobacterium tuberculosis clinical isolates by pyrosequencing","volume":"50","author":"Engstrom A.","year":"2012","unstructured":"Engstrom A., , Morcillo N., , Imperiale B., , Hoffner S.E., , and Jureen P.. 2012. Detection of first- and second-line drug resistance in Mycobacterium tuberculosis clinical isolates by pyrosequencing. J. Clin. Microbiol. 50:2026\u20132033.","journal-title":"J. Clin. Microbiol"},{"key":"e_1_3_2_32_2","doi-asserted-by":"crossref","first-page":"3994","DOI":"10.1128\/AAC.00222-16","article-title":"Frequency and distribution of tuberculosis resistance-associated mutations between Mumbai, Moldova, and Eastern Cape","volume":"60","author":"Georghiou S.B.","year":"2016","unstructured":"Georghiou S.B., , Seifert M., , Catanzaro D., , Garfein R.S., , Valafar F., , Crudu V., , Rodrigues C., , Victor T.C., , Catanzaro A., , and Rodwell T.C.. 2016. Frequency and distribution of tuberculosis resistance-associated mutations between Mumbai, Moldova, and Eastern Cape. Antimicrob. Agents Chemother. 60:3994\u20134004.","journal-title":"Antimicrob. 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