Rapid detection of the second-line drug (SLD) resistant tuberculosis (TB) strains is challenging to prescribe an immediate adequate treatment and limit the transmission of SLD resistant strains.

The study aimed to evaluate the performance of GenoType MTBDRsl V2.0 compared to phenotypic drug susceptibility testing (pDST:MGIT960) to detect resistance to SLD of Mycobacterium tuberculosis (MTB) isolates in Tunisia, between May 2015 and December 2019.

As a matter of fact, 103 rifampicin-resistant and multidrug-resistant MTB strains were included. Discrepancies between pDST and MTBDRsl were solved by whole genome sequencing.

Compared to pDST, MTBDRsl V2.0 showed a sensitivity of 92.8% (68.5%–98.7%) in detecting resistance to fluoroquinolones. As for second-line injectable drugs, it presented a sensitivity of 80.0% (49.0%–94.3%). MTBDRsl had sensitivities of 100.0% (67.5%–100.0%), 75.0% (40.9%–92.8%) and 100.0% (60.9%–100.0%) respectively for kanamycin, capreomycin and amikacin. The specificity was 100.0% for all the drugs evaluated.

As for diagnosing XDR-TB, it had a sensitivity of 57.1% (25.0%–84.1%) and a specificity of 100.0% (96.1%–100.0%).

MTBDRsl V2.0 showed a high performance in detecting SLD resistance with a short turnaround time compared with pDST, which made it possible to start an early treatment and to maintain a low prevalence of SLD resistance and XDR-TB in Tunisia.

快速检测二线药物 (SLD) 耐药结核病 (TB) 菌株对于立即进行充分治疗并限制 SLD 耐药菌株的传播具有挑战性。

该研究旨在评估 GenoType MTBDR sl V2.0 与表型药物敏感性测试 (pDST:MGIT960) 相比的性能，以检测2015 年 5 月至 2019 年 12 月突尼斯结核分枝杆菌(MTB) 分离株对 SLD 的耐药性。

事实上，包括103种耐利福平和耐多药MTB菌株。pDST 和 MTBDR sl之间的差异通过全基因组测序解决。

与 pDST 相比，MTBDR sl V2.0 在检测氟喹诺酮类药物耐药性方面的灵敏度为 92.8% (68.5%–98.7%)。对于二线注射药物，其敏感性为 80.0%（49.0%–94.3%）。MTBDR sl对卡那霉素、卷曲霉素和阿米卡星的敏感性分别为 100.0% (67.5%–100.0%)、75.0% (40.9%–92.8%) 和 100.0% (60.9%–100.0%)。所有评估的药物的特异性为 100.0%。

至于诊断 XDR-TB，其敏感性为 57.1%（25​​.0%–84.1%），特异性为 100.0%（96.1%–100.0%）。

与 pDST 相比， MTBDR sl V2.0 在检测 SLD 耐药性方面表现出很高的性能，而且周转时间短，这使得在突尼斯开始早期治疗并保持 SLD 耐药性和 XDR-TB 的低流行率成为可能。