{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T12:02:51Z","timestamp":1770984171245,"version":"3.50.1"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T00:00:00Z","timestamp":1639612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"USAID","doi-asserted-by":"crossref","award":["5U01CI000628"],"award-info":[{"award-number":["5U01CI000628"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Rapid and early detection of drug susceptibility among multidrug-resistant tuberculosis (MDR-TB) patients could guide the timely initiation of effective treatment and reduce transmission of drug-resistant TB. In the current study, we evaluated the diagnostic performance of GenoType MTBDR<jats:italic>sl<\/jats:italic> (MTBDR<jats:italic>sl<\/jats:italic>) ver1.0 assay for detection of resistance to ofloxacin (OFL), kanamycin (KAN) and ethambutol (EMB), and additionally the XDR-TB among MDR-TB patients in Bangladesh.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The MTBDR<jats:italic>sl<\/jats:italic> assay was performed directly on 218 smear-positive sputum specimens collected from MDR-TB patients and the results were compared with the phenotypic drug susceptibility testing (DST) performed on solid Lowenstein-Jensen (L-J) media. We also analyzed the mutation patterns of <jats:italic>gyrA<\/jats:italic>, <jats:italic>rrs<\/jats:italic>, and <jats:italic>embB<\/jats:italic> genes for detection of resistance to OFL, KAN and EMB, respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The sensitivity and specificity of the MTBDR<jats:italic>sl<\/jats:italic> compared to phenotypic L-J DST were 81.8% (95% CI, 69.1\u201390.9) and 98.8% (95% CI, 95.6\u201399.8), respectively for OFL (PPV: 95.7% &amp; NPV: 94.1%); 65.1% (95% CI, 57.5\u201372.2) and 86.7% (95% CI, 73.2\u201394.9), respectively for EMB (PPV: 94.9% &amp; NPV: 39.4%); and 100% for KAN. The diagnostic accuracy of KAN, OFL and EMB were 100, 94.5 and 69.6%, respectively. Moreover, the sensitivity, specificity and diagnostic accuracy of MtBDR<jats:italic>sl<\/jats:italic> for detection of XDR-TB was 100%. The most frequently observed mutations were at codon D94G (46.8%) of <jats:italic>gyr<\/jats:italic>A gene, A1401G (83.3%) of <jats:italic>rrs<\/jats:italic> gene, and M306V (41.5%) of the <jats:italic>emb<\/jats:italic>B gene.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Considering the excellent performance in this study we suggest that MTBDR<jats:italic>sl<\/jats:italic> assay can be used as an initial rapid test for detection of KAN and OFL susceptibility, as well as XDR-TB directly from smear-positive sputum specimens of MDR-TB patients in Bangladesh.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0261329","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T18:39:10Z","timestamp":1639679950000},"page":"e0261329","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Performance of GenoType MTBDRsl assay for detection of second-line drugs and ethambutol resistance directly from sputum specimens of MDR-TB patients in Bangladesh"],"prefix":"10.1371","volume":"16","author":[{"given":"S. M. Mazidur","family":"Rahman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rumana","family":"Nasrin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8749-0337","authenticated-orcid":true,"given":"Arfatur","family":"Rahman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahriar","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Razia","family":"Khatun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Khaja Mafij","family":"Uddin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md. Mojibur","family":"Rahman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5121-1962","authenticated-orcid":true,"given":"Sayera","family":"Banu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,12,16]]},"reference":[{"key":"pone.0261329.ref001","volume-title":"Global tuberculosis report 2020","author":"WHO","year":"2020"},{"key":"pone.0261329.ref002","unstructured":"WHO. Impact of the COVID-19 Pandemic on TB Detection and Mortality in 2020. 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