Rapid detection of rifampicin resistance in M. tuberculosis by phage assay

Increase in multidrug-resistant M. tuberculosis (MDR-TB) has become a great cause of concern and rifampicin resistance is considered to be a good predictor of MDR-TB in many parts of the world. Its rapid detection will allow alteration in treatment regimens in time to reduce the spread of the disease. Detection of rifampicin resistance by phage assay is a useful tool as mycobacteriophages are specific for M. tuberculosis complex and detect viable cells only. In our study, we analyzed 85 samples for rifampicin resistance using a novel mycobacteriophage based test (Phage assay) and radiometric BACTEC 460 TB. Of the 85 samples, 70 (82.35%) were resistant and 12 (14.10%) were sensitive by both methods. Our study yielded a sensitivity and specificity of 100% and 80% respectively. A good correlation was observed with conventional LJ proportion method. We conclude that phage assay allows determination of rifampicin resistance within 48 hours from culture, reducing the time taken to define susceptibility results by BACTEC 460 TB and LJ proportion method (5-7 days and 6-8 weeks respectively).