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Reporting the Result of First-line Line Probe Assay [FL-LPA] in Special Cases
Learning ObjectivesLearn about specific scenarios that may require careful interpretation and reporting of FL-LPA results.
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Reporting Drug-resistance in Special Cases
- When specimen tested contains hetero resistant strain:
- Strips contain both wild type and mutant probes for three genes known for resistance to Rifampicin and Isoniazid
- Bands to be interpreted as indicating resistance to a particular drug; should be reported as such
- Example of hetero resistant strain: rpoB WT 8 and rpoB MUT 3 bands are present
- Strips contain both wild type and mutant probes for three genes known for resistance to Rifampicin and Isoniazid
- The tested specimen contains more than one Mycobacterium tuberculosis complex strain (due to mixed culture/ non-tuberculous mycobacterium or contamination):
- If any strains harbor mutation, one mutation probe, as well as the corresponding wild type probe, may stain positive; ascertain the presence of TUB band
- Repeat test or phenotypic testing to confirm resistance
- Presence of non-tuberculous mycobacterium:
- TUB band missing; not be reported as M. tuberculosis
- TUB band absent but random banding patterns visible, eg: bands at rpoB WT 1, 4, 5 or 8; not be reported as M. tuberculosis
Resources
- GenoType MTBDR plus Ver 2.0 Kit, Instructions for Use.
- Line Probe Assays for Drug-resistant Tuberculosis Detection, GLI.
- Molecular Detection of Drug-resistant Tuberculosis by Line Probe Assay.
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