Standardization of first and second-line antitubercular susceptibility testing using BacT Alert 3D system: a report from a tertiary care centre in India

ABSTRACT

Resurgence of multidrug resistant tuberculosis has lead to demand for rapid susceptibility testing. Conventional methods take > 3 weeks and are tedious. Automated methods have superseded them for first line drug susceptibility testing. An attempt was made to standardize first and second line susceptibility testing using the BacT Alert 3D system (Biomerieux). And compare results with Lowenstein Jensen's (LJ) method. 121 isolates of Mycobacterium tuberculosis, 67 pulmonary and 54 extra pulmonary were subjected to sensitivity to first and second line drugs. Multidrug resistance was detected equally by both methods at 15.7 percent. 100 percent agreement was observed between the two methods for aminoglycosides, rifampicin, ethionamide and ciprofloxacin. 91.5 percent agreement was observed for isoniazid, 85 percent for pyrazinamide and 72.4 percent for ethambutol. The time taken by LJ method was 18-32 days and BacT Alert 3D system took 4-12 days. In the lesser developed nations where tuberculosis is rampant a rapid effective method for confirming multidrug resistant tuberculosis is definitely desirable and the BacT Alert 3D system was found an effective method when compared to the 'gold standard' LJ proportion.