Abstract:

Objective Through the comparison of the cost of MGIT 960 and melting curve technology, to evaluate the feasibility of melting curve technology in detection of MTB drug resistance at tuberculosis control and prevention institutions in different regions and levels in China. Methods Six TB designated hospitals were selected, including Xi’an Chest Hospital, Xinjiang Uygur Autonomous Region Chest Hospital, Shenyang Chest Hospital, Nanyang Sixth People’s Hospital, Zunyi Medical College Affiliated Hospital and Hangzhou Red Cross Hospital. Cost data of MGIT 960 and melting curve techniques were collected for three times, according to three workloads of high, medium and low. The unit detection cost of each method and the unit cost of one MDR-TB patient detection were calculated by “element method”. Results The average unit detection costs of MGIT 960 and melting curve technique were 702.6 yuan (4215.8/6) and 440.7 yuan (2644.3/6), respectively. When the sensitivity of the melting curve technique was greater than 70% and the prevalence of MDR-TB was ≤50% in TB patients, the average cost of one MDR-TB patient detected by the melting curve technique (when the sensitivity of the melting curve technique was 70.0%, the prevalence of MDR-TB in TB patients were 1.0%, 5.0%, 10.0%, 15.0%, 20.0%, 30.0%, 50.0%) were 62957.1, 12591.4, 6295.7, 4197.1, 3147.9, 2098.6, and 1259.1 yuan. When the sensitivity of the melting curve technology was 80.0%, the average cost were 55087.5, 11017.5, 5508.8, 3672.5, 2754.3, 1836.3, 1101.8 yuan respectively, which was lower than that of MGIT 960 (the average cost were 70260.0, 14052.0, 7026.0, 4684.0, 3513.0, 2342.0, and 1405.2 yuan). Conclusion Compared with MGIT 960, melting curve technology is a more cost-effective diagnostic method, and has the value of detecting MTB resistance in TB control institutions with different levels in different regions in China.

Key words: Mycobacterium tuberculosis, Molecular diagnostic techniques, Microbial sensitivity tests, Costs and cost analysis