Evaluation of Multiplex Allele-specific Polymerase Chain Reaction as an Alternative to Rapid Diagnosis of Multidrug-resistant Tuberculosis in Clinical Isolates

The emergence of multidrug-resistant tuberculosis (MDR-TB) cases pose a serious threat to tuberculosis control programs globally. MDR-TB is associated with higher treatment failure rates, transmission rates, and mortality. Thus, the rapid diagnosis and prevention of transmission of MDR-TB in the community become very important. The gold standard for MDR-TB testing is culture-based drug-susceptibility testing (DST), where this method has the main disadvantage of being very long testing results because it depends on the slow replication of Mycobacterium tuberculosis. Cartridge-based nucleic acid amplification test-based diagnostic tools have been developed. This tool can identify MDR-TB quickly however, the operational costs are relatively expensive and the availability of operational material is still an obstacle in developing countries. One of the methods of rapid molecular diagnostic is Multiplex Allele-specific Polymerase Chain Reaction (MAS-PCR) method which can be chosen for rapid diagnosis of MDR-TB. This MAS-PCR examination method is based on a multiplex PCR for the detection of genetic mutations in MDR-TB that is relatively more affordable, simple, and can be carried out by almost all molecular laboratories including in developing countries with good specificity and sensitivity. This study aims to evaluate the validity of the MAS-PCR method for MDR-TB diagnosis. From the results of this study, it showed MAS-PCR methods has 100% specificity and 90 % specificity compared to DST to identify MDR-TB in 20 samples of MDR- TB from clinical isolates. This result showed that MAS-PCR is a promising method to be applied for MDR-TB identification in the developing country.