A novel reporter phage to detect tuberculosis and rifampin resistance in a high-HIV-burden population

Max R. O'Donnell, Alexander Pym, Paras Jain, Vanisha Munsamy, Allison Wolf, Farina Karim, William R. Jacobs, Michelle H. Larsen

Research output: Contribution to journalArticle

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Abstract

Improved diagnostics and drug susceptibility testing for Mycobacterium tuberculosis are urgently needed. We developed a more powerful mycobacteriophage (ℙ<sup>2</sup> GFP10) with a fluorescent reporter. Fluorescence-activated cell sorting (FACS) allows for rapid enumeration of metabolically active bacilli after phage infection. We compared the reporter phage assay to GeneXpert MTB/RIF for detection of M. tuberculosis and rifampin (RIF) resistance in sputum. Patients suspected to have tuberculosis were prospectively enrolled in Durban, South Africa. Sputum was incubated with ℙ<sup>2</sup> GFP10, in the presence and absence of RIF, and bacilli were enumerated using FACS. Sensitivity and specificity were compared to those of GeneXpert MTB/RIF with an M. tuberculosis culture as the reference standard. A total of 158 patients were prospectively enrolled. Overall sensitivity for M. tuberculosis was 95.90% (95% confidence interval (CI), 90.69% to 98.64%), and specificity was 83.33% (95% CI, 67.18% to 93.59%). In acid-fast bacillus (AFB)-negative sputum, sensitivity was 88.89% (95% CI, 73.92% to 96.82%), and specificity was 83.33% (95% CI, 67.18% to 93.59%). Sensitivity for RIF-resistant M. tuberculosis in AFB-negative sputum was 90.00% (95% CI, 55.46% to 98.34%), and specificity was 91.94% (95% CI, 82.16% to 97.30%). Compared to GeneXpert, the reporter phage was more sensitive in AFB smear-negative sputum, but specificity was lower. The ℙ<sup>2</sup> GFP10 reporter phage showed high sensitivity for detection of M. tuberculosis and RIF resistance, including in AFB-negative sputum, and has the potential to improve phenotypic testing for complex drug resistance, paucibacillary sputum, response to treatment, and detection of mixed infection in clinical specimens.

Original languageEnglish (US)
Pages (from-to)2188-2194
Number of pages7
JournalJournal of Clinical Microbiology
Volume53
Issue number7
DOIs
StatePublished - Jul 1 2015

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Rifampin
Sputum
Bacteriophages
Mycobacterium tuberculosis
Tuberculosis
HIV
Bacillus
Confidence Intervals
Population
Acids
Flow Cytometry
Mycobacteriophages
Bacillus Phages
South Africa
Coinfection
Drug Resistance
Sensitivity and Specificity
Infection
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Microbiology (medical)

Cite this

A novel reporter phage to detect tuberculosis and rifampin resistance in a high-HIV-burden population. / O'Donnell, Max R.; Pym, Alexander; Jain, Paras; Munsamy, Vanisha; Wolf, Allison; Karim, Farina; Jacobs, William R.; Larsen, Michelle H.

In: Journal of Clinical Microbiology, Vol. 53, No. 7, 01.07.2015, p. 2188-2194.

Research output: Contribution to journalArticle

O'Donnell, Max R. ; Pym, Alexander ; Jain, Paras ; Munsamy, Vanisha ; Wolf, Allison ; Karim, Farina ; Jacobs, William R. ; Larsen, Michelle H. / A novel reporter phage to detect tuberculosis and rifampin resistance in a high-HIV-burden population. In: Journal of Clinical Microbiology. 2015 ; Vol. 53, No. 7. pp. 2188-2194.
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AU - Karim, Farina

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