HAINS Mycobacterium tuberculosis Second-Line Drug Test: Booking, Price, and Results

The HAINS Mycobacterium tuberculosis second-line drug test is a specialised molecular assay that detects resistance to second-line anti-tuberculosis drugs in TB-causing bacteria. It is also known as the MTBDRsl or GenoType MTBDRsl assay. Doctors prescribe this test when a patient has already been diagnosed with rifampicin-resistant TB (RR-TB) or multidrug-resistant TB (MDR-TB) and needs further assessment before starting second-line treatment. The test is performed on sputum, bronchoalveolar lavage, gastric aspirate, pus, tissue biopsy, body fluids, a culture isolate, or other clinically indicated specimens using a next-generation sequencing (NGS) method.

This test is ordered when standard TB treatment has not worked, and doctors need to understand which second-line drugs the bacteria will respond to. Below are the common reasons a doctor may request it.

Common Symptoms That May Require This Test

Patients who are already under TB treatment and show the following symptoms may be assessed for drug resistance:

• Persistent cough lasting more than two weeks despite ongoing treatment
• Fever, chills, and night sweats that do not resolve
• Unexplained fatigue and muscle weakness
• Continued weight loss during treatment
• Shortness of breath or chest discomfort

Conditions This Test Can Help Detect

The HAINS Mycobacterium tuberculosis second-line drug test helps identify several serious forms of drug-resistant TB:

• Multidrug-resistant TB (MDR-TB): resistance to at least isoniazid and rifampicin, the two most potent first-line TB drugs
• Pre-XDR-TB: MDR-TB with additional resistance to either fluoroquinolones or second-line injectable drugs
• Extensively drug-resistant TB (XDR-TB): resistance to rifampicin plus at least one fluoroquinolone and at least one other Group A drug, such as bedaquiline or linezolid
• Treatment failure cases requiring a change in therapy

HAINS Mycobacterium tuberculosis Second-Line Drug Test for Chronic Disease Monitoring

The World Health Organisation recommends this assay as an initial test to detect resistance to fluoroquinolones and second-line injectable drugs in confirmed RR-TB or MDR-TB patients, instead of waiting for slower culture-based testing. In patients on long-term drug-resistant TB treatment, this second-line drug susceptibility test helps monitor treatment effectiveness and identify emerging resistance. Tracking resistance patterns through such assays can guide clinicians in adjusting regimens to improve outcomes.

The HAINS Mycobacterium tuberculosis second-line drug test can be performed on several sample types. The collection process differs by sample type, as described below.

Sputum (expectorated or induced):

1. Rinse your mouth with plain water just before collection.
2. Take two deep breaths, hold each for a few seconds, then exhale slowly to loosen secretions in the lungs.
3. Take another deep breath, hold briefly, and cough deeply to bring up material from the lungs (not just saliva).
4. Hold the sterile container close to your lips and spit the sputum directly into it; if the amount is insufficient, cough again until enough material is collected (at least 3 ml).
5. Close the container tightly, label it, and hand it over to the collection team immediately.
6. The sample is refrigerated at 2 to 8°C and transported to the laboratory, where it undergoes DNA extraction, multiplex PCR amplification, and reverse hybridisation analysis.

Bronchoalveolar Lavage (BAL) and Bronchial Wash:

1. This procedure is performed by a doctor or trained specialist, usually in a clinical or hospital setting.
2. A thin flexible tube (bronchoscope) is passed through the nose or mouth into the airways.
3. A small amount of sterile fluid is introduced into the lower airways and then gently suctioned back, collecting cells and secretions.
4. The fluid is collected in a sterile container, sealed, and labelled.
5. The sample is refrigerated promptly and dispatched to the laboratory for molecular testing.

Gastric Aspirate (primarily used in young children):

1. This procedure is carried out by a trained healthcare professional, usually in the early morning before the child has eaten.
2. A thin tube is passed through the nose into the stomach to collect fluid that contains swallowed respiratory secretions.
3. The aspirate is placed into a sterile container, sealed, and labelled immediately.
4. The sample is refrigerated and transported to the laboratory with the clinical history.

Pus, Tissue Biopsy, and Body Fluids:

1. These samples are collected by a doctor during a clinical procedure such as a biopsy, aspiration, or surgical drainage.
2. The collected material is placed into a sterile container in sufficient volume (minimum 5 ml where possible).
3. The container is sealed tightly, labelled, and refrigerated at 2 to 8°C.
4. The sample is transported to the laboratory as quickly as possible with a complete clinical history attached.

Culture Isolate:

1. If you already have a confirmed TB culture from a previous test, the laboratory can use that isolate directly.
2. The culture isolate is transferred into an appropriate sterile container and sent to the Lupin Diagnostics laboratory.
3. The laboratory performs DNA extraction and the line probe assay on the isolate.

Results are reported qualitatively. Your doctor will review the findings together with your clinical history and previous test results. The reference ranges below give a general guide to what the results mean.

These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.

The following general wellness practices support TB management and overall respiratory health:

• Complete the full prescribed course of TB treatment without interruption, even when symptoms improve, to prevent resistance from developing or worsening
• Maintain good ventilation in your living and sleeping spaces and practise cough hygiene (cover your mouth when coughing)
• If TB is diagnosed, speak with your doctor about testing for HIV, as co-infection requires coordinated care planning

1. Select the test on the Lupin Diagnostics website.
2. Choose your city and preferred time slot.
3. Opt for home sample collection by a certified phlebotomist, or visit your nearest Lupin Diagnostics centre.
4. Receive your report via email or WhatsApp within the stipulated turnaround time.