PT  - JOURNAL ARTICLE
AU  - Piamlarp Sangsayunh
AU  - Krisana Cheewakul
AU  - Chareon Chuchothawon
TI  - Genotype MTBDR (Hain) test in suspected MDR-TB patients
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P2788
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P2788.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P2788.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - Introduction: Diagnosis of MDR-TB in Thailand was delayed because of insufficient investigation. Hain Test was a new easy and rapid technology.Aims: To evaluate accuracy of Hain test compared with conventional culture. To evaluate the judgment of chest physician for starting treatment.Method: Diagnostic and observational study, 100 previous TB treatment and suspected MDR-TB patients who attended Central Chest institute were inclusion between Sep- Dec 2012. They were assessed direct smear test, conventional culture and DST.Physician judgments of MDR-TB treatments were observed. Results: 53 patients of failure, 23 of relapse, 24 of default were inclusion.Periods of time from first diagnosis of TB until suspected MDR-TB were 4-240 months. 65%, 31 %, 4 % samples of Hain test were M.TB positive, negative, and MOTT positive. DST of Hain test showed 46 % were IR resistance,10 %INH and 3%RF resistance alone. Sensitivity, specificity, PPV, NPVof MDR-TB Hain test were 85%,79%,46%,96%.7 had positive MOTT(M. abscessus) in conventional culture and only 1 patients has positive Hain test together.Sensitivity, specificity, PPV, NPV for MOTT diagnosis of Hain test were 14%, 96%, 25%, 92%.The 63 % chest physicians judged to treat following Hain test. There was correlation between judgments of starting MDR-TB treatment and IR resistance Hain test report (p=0.03). No correlation between judgments and pattern of previous TB treatment(p=0.16), and periods of time from first to suspected MDR-TB (p= 0.18) were demonstrated.Conclusion: We recommended using Hain test in diagnosis of MDR-TB in highly suspected case and waiting for conventional culture in MOTT.Most physicians decided to start MDR-TB regimens after receive IR resistance Hain test report.