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Proficiency of drug susceptibility testing of Mycobacterium tuberculosis against pyrazinamide: the Swedish experience

Hoffner, S.; Angeby, K.; Sturegård, Erik LU ; Jonsson, B.; Johansson, A.; Sellin, M. and Werngren, J. (2013) In The International Journal of Tuberculosis and Lung Disease 17(11). p.1486-1490
Abstract
BACKGROUND: Pyrazinamide (PZA) is a key drug in the treatment of tuberculosis (TB), including multidrug-resistant TB. Drug susceptibility testing (DST) of Mycobacterium tuberculosis against PZA is not included in the World Health Organization's yearly proficiency testing. There is an increasing need to establish quality control of PZA DST. OBJECTIVE: To evaluate the performance of PZA DST and to introduce a quality assurance system for the test in Sweden. METHOD: Panels with PZA-susceptible and -resistant isolates were used in three rounds of proficiency testing in all five Swedish clinical TB laboratories and our reference laboratory. All laboratories used the MGIT 960 system. Minimum inhibitory concentrations (MICs) were determined and... (More)
BACKGROUND: Pyrazinamide (PZA) is a key drug in the treatment of tuberculosis (TB), including multidrug-resistant TB. Drug susceptibility testing (DST) of Mycobacterium tuberculosis against PZA is not included in the World Health Organization's yearly proficiency testing. There is an increasing need to establish quality control of PZA DST. OBJECTIVE: To evaluate the performance of PZA DST and to introduce a quality assurance system for the test in Sweden. METHOD: Panels with PZA-susceptible and -resistant isolates were used in three rounds of proficiency testing in all five Swedish clinical TB laboratories and our reference laboratory. All laboratories used the MGIT 960 system. Minimum inhibitory concentrations (MICs) were determined and the pncA gene was sequenced to further characterise the 52 panel strains. RESULTS: Good agreement was seen between the phenotypic PZA DST and pncA sequence data, and MIC determination confirmed high levels of resistance. However, in contrast to other drugs, for which correct proficiency test results were observed, specificity problems occurred for PZA DST in some laboratories. CONCLUSIONS: In Sweden, using panel testing, differences were seen in the proficiency of TB laboratories in correctly identifying PZA susceptibility. Improved results were noted in the third round; PZA has therefore been included in yearly proficiency testing. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
tuberculosis, pyrazinamide, proficiency testing, MDR-TB
in
The International Journal of Tuberculosis and Lung Disease
volume
17
issue
11
pages
1486 - 1490
publisher
International Union against Tuberculosis and Lung Disease
external identifiers
  • wos:000326425900021
  • scopus:84888096184
ISSN
1815-7920
DOI
10.5588/ijtld.13.0195
language
English
LU publication?
yes
id
01f2f152-4da0-45e9-93e4-b39feec83909 (old id 4200984)
date added to LUP
2014-01-02 16:44:40
date last changed
2019-02-20 03:19:46
@article{01f2f152-4da0-45e9-93e4-b39feec83909,
  abstract     = {BACKGROUND: Pyrazinamide (PZA) is a key drug in the treatment of tuberculosis (TB), including multidrug-resistant TB. Drug susceptibility testing (DST) of Mycobacterium tuberculosis against PZA is not included in the World Health Organization's yearly proficiency testing. There is an increasing need to establish quality control of PZA DST. OBJECTIVE: To evaluate the performance of PZA DST and to introduce a quality assurance system for the test in Sweden. METHOD: Panels with PZA-susceptible and -resistant isolates were used in three rounds of proficiency testing in all five Swedish clinical TB laboratories and our reference laboratory. All laboratories used the MGIT 960 system. Minimum inhibitory concentrations (MICs) were determined and the pncA gene was sequenced to further characterise the 52 panel strains. RESULTS: Good agreement was seen between the phenotypic PZA DST and pncA sequence data, and MIC determination confirmed high levels of resistance. However, in contrast to other drugs, for which correct proficiency test results were observed, specificity problems occurred for PZA DST in some laboratories. CONCLUSIONS: In Sweden, using panel testing, differences were seen in the proficiency of TB laboratories in correctly identifying PZA susceptibility. Improved results were noted in the third round; PZA has therefore been included in yearly proficiency testing.},
  author       = {Hoffner, S. and Angeby, K. and Sturegård, Erik and Jonsson, B. and Johansson, A. and Sellin, M. and Werngren, J.},
  issn         = {1815-7920},
  keyword      = {tuberculosis,pyrazinamide,proficiency testing,MDR-TB},
  language     = {eng},
  number       = {11},
  pages        = {1486--1490},
  publisher    = {International Union against Tuberculosis and Lung Disease},
  series       = {The International Journal of Tuberculosis and Lung Disease},
  title        = {Proficiency of drug susceptibility testing of Mycobacterium tuberculosis against pyrazinamide: the Swedish experience},
  url          = {http://dx.doi.org/10.5588/ijtld.13.0195},
  volume       = {17},
  year         = {2013},
}