TB or not TB? Definitive determination of species within the Mycobacterium tuberculosis complex in unprocessed sputum from adults with presumed multidrug-resistant tuberculosis.

Tropical Medicine & International Health : TM & IH
Peter M MbeleleStellah Mpagama

Abstract

Differences among Mycobacterium tuberculosis complex (MTC) species may predict drug resistance or treatment success. Thus, we optimised and deployed the genotype MTBC assay (gMTBC) to identify MTC to the species level, and then performed comparative genotypic drug-susceptibility testing to anti-tuberculosis drugs from direct sputum of patients with presumed multidrug-resistant tuberculosis (MDR-TB) by the MTBDRplus/sl reference method. Patients with positive Xpert® MTB/RIF (Xpert) results were consented to provide early-morning-sputum for testing by the gMTBC and the reference MTBDRplus/sl. Chi-square or Fisher's exact test compared proportions. Modified Poisson regression modelled detection of MTC by gMTBC. Among 73 patients, 53 (73%) were male and had a mean age of 43 (95% CI; 40-45) years. In total, 34 (47%), 36 (49%) and 38 (55%) had positive gMTBC, culture and MTBDR respectively. Forty patients (55%) had low quantity MTC by Xpert, including 31 (78%) with a negative culture. gMTBC was more likely to be positive in patients with chest cavity 4.18 (1.31-13.32, P = 0.016), high-quantity MTC by Xpert 3.03 (1.35-6.82, P = 0.007) and sputum smear positivity 1.93 (1.19-3.14, P = 0.008). The accuracy of gMTBC in detecting MTC was 9...Continue Reading

References

Apr 10, 2014·American Journal of Respiratory and Critical Care Medicine·Catherine W M OngJon S Friedland
Nov 29, 2015·Asian Pacific Journal of Tropical Medicine·Abubakar S HozaBrigitte König
Feb 26, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Grant TheronKeertan Dheda
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Apr 28, 2018·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Nicholaus Peter MnyambwaSayoki G Mfinanga
Dec 12, 2018·International Journal of Mycobacteriology·Peter M MbeleleStellah G Mpagama
Oct 23, 2019·South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde·L PitsoA Van der Spoel van Dijk
Mar 3, 2020·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·Desmond HsuSimon Tiberi
Mar 26, 2021·The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union Against Tuberculosis and Lung Disease·B W AllwoodK Mortimer

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