Diagnostic performance of the AID line probe assay in the detection of Mycobacterium tuberculosis and drug resistance in Romanian patients with presumed TB

PLoS One. 2022 Aug 10;17(8):e0271297. doi: 10.1371/journal.pone.0271297. eCollection 2022.

Abstract

Background: The AID line probe assay has shown promising evaluation data on the detection of Mycobacterium tuberculosis as well as 1st- and 2nd-line drug resistance, using isolates and selected clinical samples in previous studies.

Methods: The diagnostic performance of three AID-modules (AID INH/RIF, AID FQ/EMB and AID AG) was analyzed in sputum samples from patients with presumed tuberculosis against culture methods and phenotypic drug resistance as reference standards.

Results: 59 patients had culture-confirmed tuberculosis. All AID modules showed moderate sensitivity (46/59, 78.0%, 65.3-87.7) and very good specificity (100%, 95.5%, 93.7%). There was a high proportion of invalid tests, resulting in 32.6%, 78.3% and 19.6% of 46 AID-positive tuberculosis cases, who could not be assessed for drug resistance by the AID INH/RIF-, AID FQ/EM- and AID AG-module, respectively. A small number of patients showed drug resistance by reference standards: Three MDR-TB cases plus three, one and one patients with resistance to streptomycin, fluoroquinolones and aminoglycosides, respectively. The AID-assay detected all MDR-TB cases, two of three streptomycin-resistant TB cases, one of one of fluoroquinolone-resistant and missed one aminoglycoside-resistant TB case.

Discussion: The high proportion of invalid results precludes the use of the AID-assay from direct sputum-based tuberculosis and drug-resistance testing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antitubercular Agents / pharmacology
  • Antitubercular Agents / therapeutic use
  • Drug Resistance
  • Fluoroquinolones
  • Humans
  • Microbial Sensitivity Tests
  • Mycobacterium tuberculosis*
  • Rifampin
  • Romania
  • Streptomycin
  • Tuberculosis, Lymph Node* / drug therapy
  • Tuberculosis, Multidrug-Resistant* / diagnosis
  • Tuberculosis, Multidrug-Resistant* / drug therapy
  • Tuberculosis, Multidrug-Resistant* / microbiology

Substances

  • Antitubercular Agents
  • Fluoroquinolones
  • Rifampin
  • Streptomycin

Grants and funding

The study was funded through the German Center for Infection Research (DZIF), TTU 02.804. The AID tests as well as equipment and reagents needed for the conduct of AID-tests were provided by the AID Diagnostika GmbH, Ebinger Strasse 4, D-72479 Straßberg. The AID Diagnostika GmbH was not involved in study design, data analysis and writing of this manuscript.