Analysis of Xpert MTB/RIF results in retested patients with very low initial bacterial loads: A retrospective study in China

Wang, Jun; Zhang, Xuxia; Huo, Fengmin; Lin, Qin; Liu, Rongmei; Shang, Yuanyuan; Yao, Cong; Ma, Li

doi:10.1016/j.jiph.2023.04.004

Cited by 2 publications

(2 citation statements)

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“…The most commonly used molecular tests were Hain MTBDRplus, MTBDRsl and the GenXpert systems. Regarding the GenXpert, its performance is less optimal when the assay is performed in paucibacillary samples and low RIF-resistance settings, see for example [28,29,36], where the authors reported false-positive results. In those conditions, it is recommended to repeat the Xpert testing in case of a first positive result.…”

Section: Discussionmentioning

confidence: 99%

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Exploring Diagnostic Methods for Drug-Resistant Tuberculosis: A Comprehensive Overview

Sanchini,

Lanni,

Giannoni

et al. 2024

Preprint

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Despite available global efforts and funding, Tuberculosis (TB) continues to affect a considerable number of patients worldwide. Policy makers and stakeholders set clear goals to reduce TB incidence and mortality, but the emergence of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) complicate the reach of these goals. Drug-resistance TB needs to be diagnosed rapidly and accurately to effectively treat patients, prevent the transmission of MDR-TB, minimise mortality, reduce treatment costs and avoid unnecessary hospitalisations. In this narrative review, we provide a comprehensive overview of laboratory methods for detecting drug resistance in MTB, focusing on phenotypic, molecular and other drug susceptibility testing (DST) techniques. We found a large variety of methods used, with the BACTEC MGIT 960 being the most common phenotypic DST and the Xpert MTB/RIF being the most common molecular DST. We emphasise the importance of integrating phenotypic and molecular DST to address issues like resistance to new drugs, heteroresistance, mixed infections and low-level resistance mutations. Notably, most of the analysed studies adhered to the outdated definition of XDR-TB and did not consider the pre-XDR definition, thus posing challenges in aligning diagnostic methods with the current landscape of TB resistance.

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Section: Discussionmentioning

confidence: 99%

“…Culture and MGIT results further corroborated this, with 36 of the initially RIF-resistant isolates turning out to be culture-negative. The study emphasized that the Xpert MTB/RIF test may yield a significant number of false-resistant results when dealing with paucibacillary samples [29].…”

Section: Xpert Mtb/rif Xpert Mtb/rif Ultra and Xpert Mtb/xdrmentioning

confidence: 99%