January - March 2017: 
Volume 30, Issue 1

Click on the image to download the Issue in PDF format.


Pneumon 2017, 30(1):24-31
Drug susceptibility testing of first-line anti-tuberculosis drugs: clinical evaluation of the differences between laboratories
Authors Information

1: Pulmonary Department, Aristotle University of Thessaloniki, “G. Papanikolaou” Hospital, Thessaloniki, Greece
2: Greek National Reference Laboratory for Mycobacteria, General Hospital for Chest Diseases “SOTIRIA”, Athens, Greece
3: Laboratory for Tuberculosis of Northern Greece, “G. Papanikolaou” Hospital, Thessaloniki, Greece

  1. European Centre for Disease Prevention and Control. Annual Epidemiological Report 2016 – Tuberculosis. Stockholm: ECDC; 2016. Available from: http://ecdc.europa.eu/en/healthtopics/Tuberculosis/Pages/Annual-epidemiological-report-2016.aspx.
  2. European Centre for Disease Prevention and Control, WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2016. Stockholm: ECDC; 2016.
  3. Κέντρο Ελέγχου & Πρόληψης Νοσημάτων (ΚΕΕΛΠΝΟ), Επιδη-μιολογικά δεδομένα φυματίωσης στην Ελλάδα, 2004-2010.
  4. Κέντρο Ελέγχου & Πρόληψης Νοσημάτων (ΚΕΕΛΠΝΟ), Ενημε-ρωτικό Δελτίο, Νεώτερα επιδημιολογικά δεδομένα για τη φυ-ματίωση στην Ελλάδα. http://www2.keelpno.gr/blog/?p=5056.
  5. Lytras T, Spala G, Bonovas S, Panagiotopoulos T. Evaluation of Tuberculosis Underreporting in Greece through Comparison with Anti-Tuberculosis Drug Consumption. PLoS One 2012; 7:7-12. doi:10.1371/journal.pone.0050033.
  6. Ibarz-Pavón AB, Papaventsis D, Kalkouni R, et al. Pilot study of the completeness of notification of adult tuberculosis in Ath-ens, Greece. Int J Tuberc Lung Dis 2016; 20:920-5. doi:10.5588/ijtld.15.0907.
  7. World Health Organization, Global Tuberculosis Report 2016 WHO/HTM/TB/2016.13, Geneva, Switzerland: WHO, 2016.
  8. Ahmad S, Mokaddas E, Al-Mutairi N, Eldeen HS, Mohammadi S.     Discordance across Phenotypic and Molecular Methods for Drug Susceptibility Testing of Drug-Resistant Mycobacterium tuberculosis Isolates in a Low TB Incidence Country. PLoS One 2016;11:e0153563. doi:10.1371/journal.pone.0153563.
  9. Gandhi NR, Andrews JR, Brust JCM, et al. Risk factors for mortal-ity among MDR- and XDR-TB patients in a high HIV prevalence setting.
  10. Lonnroth K, Migliori GB, Abubakar I, et al. Towards tuberculosis elimination: an action framework for low-incidence countries. Eur Respir J 2015; 45:928–52. doi: 10.1183/09031936.00214014.
  11. Drobniewski F, Nikolayevskyy V, Balabanova Y, Bang D, Papa-ventsis D. Diagnosis of tuberculosis and drug resistance: what can new tools bring us? Int J Tuberc Lung Dis 2012; 16:860–70. doi: 10.5588/ijtld.12.0180.
  12. ISO 15189:2012. Medical laboratories—Requirements for quality and competence. International Standard Organization 2012.
  13. Fattorini L, Iona E, Cirillo D, et al. External quality control of Mycobacterium tuberculosis drug susceptibility testing: results of two rounds in endemic countries. Int J Tuberc Lung Dis 2008;12:214-7.
  14. Nikolayevskyy V, Hillemann D, Richter E, et al. External Quality Assessment for Tuberculosis Diagnosis and Drug Resistance in the European Union: A Five Year Multicentre Implementa-tion Study. PLoS One 2016; 11:e0152926. doi:10.1371/journal. pone.0152926.
  15. Hillemann D, Hoffner S, Cirillo D, Drobniewski F, Richter E, Rüsch-Gerdes S. First Evaluation after Implementation of a Quality Control System for the Second Line Drug Susceptibility Testing of Mycobacterium tuberculosis Joint Efforts in Low and High Incidence Countries. PLoS One 2013; 8:1-7. doi:10.1371/journal.pone.0076765.
  16. Laszlo A, Rahman M, Espinal M, Raviglione M. Quality assurance programme for drug susceptibility testing of Mycobacterium tuberculosis in the WHO/IUATLD Supranational Reference Laboratory Network: five rounds of proficiency testing, 1994-1998. IntJTubercLungDis 2002;6:748-56.
  17. European Centre for Disease Prevention and Control. ERLN-TB expert opinion on the use of the rapid molecular assays for the diagnosis of tuberculosis and detection of drug-resistance. Stockholm: ECDC; 2013
  18. Κατευθυντήριες οδηγίες για τη θεραπεία της φυματίωσης στους ενήλικες. Πνεύμων 2015, 28:268.
  19. Steingart KR, Sohn H, Schiller I, et al. Xpert® MTB/RIF as-say for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane databaseSystRev. 2013;1:CD009593. doi:10.1002/14651858.CD009593.pub2
  20. Barnard M, Albert H, Coetzee G, O’Brien R, ME Bosman. Rapid molecular screening for multidrug-resistant tuberculosis in a high- volume public health laboratory in South Africa. Am J Respir Crit Care Med 2008; 177:787–92.
  21. Yakrus MA, Driscoll J, Lentz AJ, et al. Concordance between mo-lecular and phenotypic testing of mycobacterium tuberculosis complex isolates for resistance to rifampin and isoniazid in the United States. J Clin Microbiol 2014;52:1932-7. doi:10.1128/JCM.00417-14.
  22. Banu S, Rahman SMM, Khan MSR, et al. Discordance across several methods for drug susceptibility testing of drug-resistant Mycobacterium tuberculosis isolates in a single laboratory. J Clin Microbiol 2014; 52:156-63. doi:10.1128/JCM.02378-13.
  23. Van Deun A, Barrera L, Bastian I, et al. Mycobacterium tuber-culosis strains with highly discordant rifampin susceptibility test results. J Clin Microbiol 2009; 47:3501-6. doi:10.1128/JCM.01209-09.
  24. Rigouts L, Gumusboga M, de Rijk WB, et al. Rifampin Resistance Missed in Automated Liquid Culture System for Mycobacterium tuberculosis Isolates with Specific rpoB Mutations. Journal of Clinical Microbiology 2013; 51:2641-5. doi:10.1128/JCM.02741-12.
  25. World Health Organization. Updated interim critical concentra-tions for first-line and second-line DST (as of May 2012). 2012; http://www.stoptb.org/wg/gli/assets/documents/Updated critical concentration table_1st and 2nd line drugs.pdf
  26. Dominguez et al. Clinical implications of molecular drug resistance testing for Mycobacterium tuberculosis: a TBNET/RESIST-TB consensus statement. Int J Tuberc Lung Dis 2016; 20:24-42. doi: 10.5588/ijtld.15.0221.
  27. van Rie A, et al. 2005. Reinfection and mixed infection cause changing Mycobacterium tuberculosis drug-resistance pat-terns. Am J Respir Crit Care Med 172:636–42.
  28. Cohen T, van Helden PD, Wilson D, et al. Mixed-strain Myco-bacterium tuberculosis infections and the implications for tuberculosis treatment and control. Clin Microbiol Rev 2012; 25:708-19. doi:10.1128/CMR.00021-12.
  29. van Deun A, Aung KJM, Bola V, et al. Rifampin drug resistance tests for tuberculosis: challenging the gold standard. J Clin Microbiol 2013; 51:2633-40. doi:10.1128/JCM.00553-13.
  30. van Ingen J, Aarnoutse R, de Vries G, Boeree MJ, van Soolingen D.  Low-level rifampicin-resistant Mycobacterium tuberculosis strains raise a new therapeutic challenge. Int J Tuberc Lung Dis 2011;15:990-92. doi:10.5588/ijtld.10.0127.
  31. Williamson DA, Roberts SA, Bower JE, et al. Clinical failures associated with rpoB mutations in phenotypically occult multidrug-resistant Mycobacterium tuberculosis. Int J Tuberc Lung Dis 2012;16:216-20. doi:10.5588/ijtld.11.0178.
  32. Ioerger TR, Koo S, No E-G, et al. Genome analysis of multi- and extensively-drug-resistant tuberculosis from KwaZulu-Natal, South Africa. PLoS One 2009; 4:e7778. doi:10.1371/journal. pone.0007778.
  33. Τρυφινοπούλου Κ, Παπαβέντσης Δ, Ιωαννίδης Π, Βογιατζάκης ΕΔ. Καταγραφή μικροβιολογικών εργαστηρίων νοσηλευτικών ιδρυμάτων που εμπλέκονται στην εργαστηριακή διάγνωση της φυματίωσης. Περιγραφή εύρους διαγνωστικών εξετά-σεων και δεικτών διασφάλισης ποιότητας και βιοασφάλειας. Μικροβιολογικό Εργαστήριο & Εθνικό Κέντρο Αναφοράς Μυκοβακτηριδίων, Αθήνα, 2017.
  34. Availability of an Assay for Detecting Mycobacterium tubercu-losis, Including Rifampin-Resistant Strains, and Considerations for Its Use — United States, 2013, n.d. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6241a1.htm