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With this approach for samples with definitive results, the concordance for isoniazid susceptibility between MODS and the proportion method was 96.8% (kappa 0.89) (Table 3), and the concordance for rifampicin susceptibility was 92.6% (kappa 0.80) (Table 4).
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Currently available techniques for susceptibility testing are culture based, and include the proportion method (PM), resistance ratio and absolute concentration method.
Drug susceptibility testing was performed at the Sudanese National Reference Laboratory (Khartoum) for isoniazid, rifampicin, streptomycin and ethambutol by the proportion method on LJ [ 20].
In this study Mycobacterium tuberculosis isolates from 235 patients attending three treatment centers in Sudan were screened for susceptibility to isoniazid, rifampicin, ethambutol and streptomycin by the proportion method on Lowenstein Jensen media.
The methods used to test for isoniazid resistance are now relatively standardized and based on the proportion method in which resistance is defined as growth on medium containing 0.2 μg/mL isoniazid that exceeds 1% of the growth on control medium (36 ).
The drug susceptibilities of isoniazid and rifampicin were performed by the proportion method and their critical concentrations for resistance were as follows: isoniazid, 0.2 μg/ml and 1.0 μg/ml; rifampicin, 1.0 μg/ml and 5.0 μg/ml (20).
Sputa from 264 TB patients were cultured in parallel in Lowenstein Jensen (LJ) and MODS assays; strains were tested for rifampicin and isoniazid susceptibility by the proportion method at the national reference laboratory.
All isolates were identified as M. tuberculosis complex by the para-nitrobenzoic acid method and tested for drug susceptibility against rifampin, isoniazid, streptomycin, and ethambutol by using the proportion method on LJ medium at the following respective concentrations: 40 µg/mL, 0.2 µg/mL, 4 µg/mL, and 2 µg/mL (7, 8 ).
DST was performed using the proportion method and Löwenstein-Jensen Löwenstein-Jensen
Standard methods for DST are based on either the proportion method and performed on solid media, or on critical concentration assays performed in liquid culture systems [ 5].
LJ medium was impregnated with isoniazid (INH), rifampicin (RIF), streptomycin (SM), and ethambutol (EMB) according to the proportion method as recommended by WHO/IUATLD [ 8, 11].
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