False-positive rifampicin resistance on Xpert® MTB/RIF: Case report and clinical implications
Date
2012
Authors
Van Rie A.
Mellet K.
John M.-A.
Scott L.
Page-Shipp L.
Dansey H.
Victor T.
Warren R.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
The World Health Organization had endorsed Xpert®MTB/RIF (Xpert) as the initial diagnostic for multidrug-resistant tuberculosis (TB) or TB suspects co-infected with the human immunodeficiency virus. We investigated an unexpected case of rifampicin (RMP) resistance on Xpert using repeat Xpert, smear microscopy, MTBDRplus assay, culture, drug susceptibility testing, spoligotyping and rpoB gene sequencing. A false-positive result was most likely, given the wild type rpoB gene sequence and exclusion of both mixed infection and mixture of drug-susceptible and drug-resistant populations. When decentralising Xpert, test performance characteristics need to be understood by health care workers and methods of confirmation of RMP resistance need to be accessible. © 2012 The Union.
Description
Keywords
antiretrovirus agent, rifampicin, tuberculostatic agent, acid fast bacterium, adult, analytical error, antibiotic resistance, antibiotic sensitivity, article, bacterial gene, bacterium culture, bacterium detection, case report, CD4 lymphocyte count, coughing, disease duration, DNA sequence, drug resistant tuberculosis, false positive result, genetic analysis, human, Human immunodeficiency virus infection, inhA gene, laboratory test, male, microscopy, mixed infection, molecular probe, Mycobacterium tuberculosis, nonhuman, priority journal, rpoB gene, sequence analysis, spoligotyping, sputum smear, treatment duration, wild type, world health organization
Citation
International Journal of Tuberculosis and Lung Disease
16
2
206
208
16
2
206
208