Microbiological diagnosis of extra-pulmonary tuberculosis (EPTB) has been one of the most difficult aspects of tuberculosis (TB) management. Availability of better imaging and diagnostic modalities has led to an increase in the number of diagnosed cases. The current upsurge in multidrug-resistant tuberculosis warrants routine testing of EPTB samples for resistance at baseline with shorter turn-around time. A total of 369 EPTB specimens were subjected to Ziehl-Neelsen (ZN) stain, liquid culture (LC) with phenotypic drug susceptibility testing, MTBDRplus V.2 and MTBDRsl V.2. The molecular categorisation of resistant specimens was further reconfirmed with sequencing. The sensitivity and specificity of MTBDRplus V.2 to detect Mycobacterium tuberculosis (MTB) when compared to ZN stain was 97.9% and 89.2%, respectively while it was 73.4% and 83.8%, respectively when compared to LC. Similarly, for MTBDRsl V.2, the sensitivity and specificity for detection of MTB when compared with ZN was 95.6% and 91.9%, respectively and 75% and 89.2%, respectively when compared to LC. In smear-positive specimens, 94% (141/150) and 86% (129/150) valid results were observed in MTBDRplus V.2 and MTBDRsl V.2, respectively. The utilisation of both MTBDRplus V.2 and MTBDRsl V.2 for the diagnosis of smear-positive EPTB specimens would be useful in programmatic management of TB in high-burden settings.

中文翻译：

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基因型 MTBDRplus V2 和基因型 MTBDRsl V2 对印度肺外结核诊断的评价

肺外结核病 (EPTB) 的微生物学诊断一直是结核病 (TB) 管理中最困难的方面之一。更好的成像和诊断方式的可用性导致诊断病例数量增加。当前耐多药结核病的激增需要在更短的周转时间内对 EPTB 样本进行基线耐药性常规检测。共有 369 份 EPTB 标本进行了 Ziehl-Neelsen (ZN) 染色、液体培养 (LC) 和表型药物敏感性测试、MTBDRplus V.2 和 MTBDRsl V.2。耐药标本的分子分类进一步通过测序再次确认。与 ZN 染色相比，MTBDRplus V.2 检测结核分枝杆菌 (MTB) 的灵敏度和特异性分别为 97.9% 和 89.2%，而分别为 73.4% 和 83.8%，分别与 LC 相比。类似地，对于 MTBDRsl V.2，与 ZN 相比，MTB 检测的灵敏度和特异性分别为 95.6% 和 91.9%，与 LC 相比分别为 75% 和 89.2%。在涂阳标本中，MTBDRplus V.2 和 MTBDRsl V.2 分别观察到 94% (141/150) 和 86% (129/150) 的有效结果。使用 MTBDRplus V.2 和 MTBDRsl V.2 诊断涂片阳性 EPTB 标本将有助于高负担环境中结核病的程序化管理。在 MTBDRplus V.2 和 MTBDRsl V.2 中分别观察到 94% (141/150) 和 86% (129/150) 的有效结果。使用 MTBDRplus V.2 和 MTBDRsl V.2 诊断涂片阳性 EPTB 标本将有助于高负担环境中结核病的程序化管理。在 MTBDRplus V.2 和 MTBDRsl V.2 中分别观察到 94% (141/150) 和 86% (129/150) 的有效结果。使用 MTBDRplus V.2 和 MTBDRsl V.2 诊断涂片阳性 EPTB 标本将有助于高负担环境中结核病的程序化管理。