Format

Send to

Choose Destination
Public Health Action. 2019 Sep 21;9(Suppl 1):S12-S18. doi: 10.5588/pha.19.0005.

Drug-resistant tuberculosis diagnosis since Xpert® MTB/RIF introduction in Papua New Guinea, 2012-2017.

Author information

1
Central Public Health Laboratory, Port Moresby, Papua New Guinea (PNG).
2
Health and HIV Implementation Services Provider, Port Moresby, PNG.
3
Queensland Mycobacterium Reference Laboratory, Pathology Queensland Central Laboratory at Royal Brisbane Hospital, Brisbane, Queensland, Australia.
4
Papua New Guinea National TB Programme, Port Moresby, PNG.
5
Burnet Institute, Melbourne, Victoria, Australia.
6
Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, New South Wales, Australia.
7
Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia.
8
School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, PNG.

Abstract

in English, French, Spanish

Setting:

Xpert® MTB/RIF was introduced in Papua New Guinea in 2012 for the diagnosis of tuberculosis (TB) and of rifampicin-resistant TB (RR-TB), a marker of multi-drug-resistant TB (MDR-TB).

Objective:

To assess the concordance of Xpert with phenotypic drug susceptibility testing (DST) performed at the supranational reference laboratory and to describe the patterns of drug-resistant TB observed.

Design:

This was a retrospective descriptive study of laboratory data collected from April 2012 to December 2017.

Results:

In 69 months, 1408 specimens with Xpert results were sent for mycobacterial culture and DST; Mycobacterium tuberculosis was cultured from 63% (884/1408) and DST was completed in 99.4%. The concordance between Xpert and culture for M. tuberculosis detection was 98.6%. Of 760 RR-TB cases, 98.7% were detected using Xpert; 98.5% of 620 MDR-TB cases were identified using phenotypic DST. Phenotypic resistance to second-line drugs was detected in 59.4% (522/879) of specimens tested, including 29 with fluoroquinolone resistance; the majority were from the National Capital District and Daru Island.

Conclusion:

The high concordance between phenotypic DST and Xpert in identifying RR-TB cases supports the scale-up of initial Xpert testing in settings with high rates of drug resistance. However, rapid DST in addition to the detection of RR-TB is required.

KEYWORDS:

Papua New Guinea; Xpert® MTB/RIF; drug susceptibility testing; multidrug-resistant tuberculosis

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center