Extract from used Xpert MTB/ RIF Ultra cartridges is useful for accurate second-line drug-resistant tuberculosis diagnosis with minimal rpoB-amplicon cross-contamination risk

dc.contributor.authorVenter, Rouxjeaneen_ZA
dc.contributor.authorMinnies, Stephanieen_ZA
dc.contributor.authorDerendinger, Brigittaen_ZA
dc.contributor.authorTshivhula, Happyen_ZA
dc.contributor.authorDe Vos, Margarethaen_ZA
dc.contributor.authorDolby, Taniaen_ZA
dc.contributor.authorRuiters, Ashleyen_ZA
dc.contributor.authorWarren, Robin M.en_ZA
dc.contributor.authorTheron, Granten_ZA
dc.date.accessioned2020-06-24T08:00:48Z
dc.date.available2020-06-24T08:00:48Z
dc.date.issued2020
dc.descriptionCITATION: Venter, R., et al. 2020. Extract from used Xpert MTB/ RIF Ultra cartridges is useful for accurate second-line drug-resistant tuberculosis diagnosis with minimal rpoB-amplicon cross-contamination risk. Scientific Reports, 10:2633, doi:10.1038/s41598-020-59164-3.
dc.descriptionThe original publication is available at https://www.nature.com
dc.descriptionPublication of this article was funded by the Stellenbosch University Open Access Fund.
dc.description.abstractXpert MTB/RIF Ultra (Ultra) detects Mycobacterium tuberculosis and rifampicin resistance. Follow-on drug susceptibility testing (DST) requires additional sputum. Extract from the diamond-shaped chamber of the cartridge (dCE) of Ultra’s predecessor, Xpert MTB/RIF (Xpert), is useful for MTBDRsl-based DST but this is unexplored with Ultra. Furthermore, whether CE from non-diamond compartments is useful, the performance of FluoroType MTBDR (FT) on  CE, and rpoB cross-contamination risk associated with the extraction procedure are unknown. We tested MTBDRsl, MTBDRplus, and FT on CEs from chambers from cartridges (Ultra, Xpert) tested on bacilli dilution series. MTBDRsl on Ultra dCE on TB-positive sputa (n = 40) was also evaluated and, separately, rpoB amplicon cross-contamination risk . MTBDRsl on Ultra dCE from dilutions ≥103 CFU/ml (CTmin <25, >“low semi-quantitation”) detected fluoroquinolone (FQ) and second-line injectable (SLID) susceptibility and resistance correctly (some SLIDs-indeterminate). At the same threshold (at which ~85% of Ultra-positives in our setting would be eligible), 35/35 (100%) FQ and 34/35 (97%) SLID results from Ultra dCE were concordant with sputa results. Tests on other chambers were unfeasible. No tubes open during 20 batched extractions had FT-detected rpoB cross-contamination. False-positive Ultra rpoB results was observed when dCE dilutions ≤10−3 were re-tested. MTBDRsl on Ultra dCE is concordant with isolate results. rpoB amplicon cross-contamination is unlikely. These data mitigate additional specimen collection for second-line DST and cross-contamination concerns.en_ZA
dc.description.urihttps://www.nature.com/articles/s41598-020-59164-3
dc.description.versionPublisher's version
dc.format.extent10 pages ; illustrations
dc.identifier.citationVenter, R., et al. 2020. Extract from used Xpert MTB/ RIF Ultra cartridges is useful for accurate second-line drug-resistant tuberculosis diagnosis with minimal rpoB-amplicon cross-contamination risk. Scientific Reports, 10:2633, doi:10.1038/s41598-020-59164-3
dc.identifier.issn2045-2322 (online)
dc.identifier.otherdoi:10.1038/s41598-020-59164-3
dc.identifier.urihttp://hdl.handle.net/10019.1/108671
dc.language.isoen_ZAen_ZA
dc.publisherNature Research (part of Springer Nature)
dc.rights.holderAuthors retain copyright
dc.subjectTuberculosis -- Diagnosisen_ZA
dc.subjectTuberculosis -- Testingen_ZA
dc.titleExtract from used Xpert MTB/ RIF Ultra cartridges is useful for accurate second-line drug-resistant tuberculosis diagnosis with minimal rpoB-amplicon cross-contamination risken_ZA
dc.typeArticleen_ZA
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