Discordance of the Repeat GeneXpert MTB/RIF Test for Rifampicin Resistance Detection Among Patients Initiating MDR-TB Treatment in Uganda.

RR/MDR-TB Repeat Xpert detection

Journal

Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 25 01 2021
accepted: 31 03 2021
entrez: 30 6 2021
pubmed: 1 7 2021
medline: 1 7 2021
Statut: epublish

Résumé

The Global Laboratory Initiative (GLI) guidelines recommend repeat for GeneXpertMTB/RIF (XpertMTB/RIF) in patients with a low pretest probability of rifampicin resistance (RR). This was a cross-sectional study using results of sputum specimens collected from participants screened for the STREAM 2 trial. We recruited all patients with XpertMTB/RIF RR-TB detected who were referred for RR/multidrug-resistant (MDR) TB treatment initiation at Mulago National Referral Hospital, Kampala, between September 2017 and October 2019. At baseline, smear microscopy, repeat XpertMTB/RIF, Xpert Ultra, and MTBDR A total of 126/130 patients had repeat XpertMTB/RIF results, of whom 97 (77.0%) had Our findings show a high false-positive rifampicin resistance rate in low-TB burden patients, which calls for repeat testing in order to prevent unnecessary prescription of anti-MDR-TB therapy.

Sections du résumé

BACKGROUND BACKGROUND
The Global Laboratory Initiative (GLI) guidelines recommend repeat for GeneXpertMTB/RIF (XpertMTB/RIF) in patients with a low pretest probability of rifampicin resistance (RR).
METHODS METHODS
This was a cross-sectional study using results of sputum specimens collected from participants screened for the STREAM 2 trial. We recruited all patients with XpertMTB/RIF RR-TB detected who were referred for RR/multidrug-resistant (MDR) TB treatment initiation at Mulago National Referral Hospital, Kampala, between September 2017 and October 2019. At baseline, smear microscopy, repeat XpertMTB/RIF, Xpert Ultra, and MTBDR
RESULTS RESULTS
A total of 126/130 patients had repeat XpertMTB/RIF results, of whom 97 (77.0%) had
CONCLUSIONS CONCLUSIONS
Our findings show a high false-positive rifampicin resistance rate in low-TB burden patients, which calls for repeat testing in order to prevent unnecessary prescription of anti-MDR-TB therapy.

Identifiants

pubmed: 34189166
doi: 10.1093/ofid/ofab173
pii: ofab173
pmc: PMC8223903
doi:

Types de publication

Journal Article

Langues

eng

Pagination

ofab173

Subventions

Organisme : World Health Organization
ID : 001
Pays : International
Organisme : FIC NIH HHS
ID : D43 TW010132
Pays : United States

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

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Auteurs

Willy Ssengooba (W)

College of Health Sciences, Makerere University Lung Institute, Kampala, Uganda.
Mycobacteriology (BSL-3) Laboratory, Department of Medical Microbiology, Makerere University, Kampala, Uganda.

Jean de Dieu Iragena (J)

Communicable Diseases Cluster, HIV/TB and Hepatitis Programme, World Health Organization Regional Office for Africa, Brazzaville, Congo.

Kevin Komakech (K)

Mycobacteriology (BSL-3) Laboratory, Department of Medical Microbiology, Makerere University, Kampala, Uganda.

Iginitius Okello (I)

College of Health Sciences, Makerere University Lung Institute, Kampala, Uganda.

Joanitah Nalunjogi (J)

College of Health Sciences, Makerere University Lung Institute, Kampala, Uganda.

Winceslaus Katagira (W)

College of Health Sciences, Makerere University Lung Institute, Kampala, Uganda.

Ivan Kimuli (I)

College of Health Sciences, Makerere University Lung Institute, Kampala, Uganda.

Susan Adakun (S)

College of Health Sciences, Makerere University Lung Institute, Kampala, Uganda.
National Tuberculosis Treatment Unit, Mulago Hospital, Kampala, Uganda.

Moses L Joloba (ML)

College of Health Sciences, Makerere University Lung Institute, Kampala, Uganda.
Mycobacteriology (BSL-3) Laboratory, Department of Medical Microbiology, Makerere University, Kampala, Uganda.

Gabriela Torrea (G)

Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.

Bruce J Kirenga (BJ)

College of Health Sciences, Makerere University Lung Institute, Kampala, Uganda.

Classifications MeSH