Are WHO approved nucleic acid amplification tests causing large-scale “false identification” of rifampicin-resistant tuberculosis?: Programmatic experience from south india

Sanker, Praveen; Ambika, Anusree P; Santhosh, Vishnu T; Kottuthodi, Ramya Puthukkudi; Balakrishnan, Ravikrishnan; Mrithunjayan, Sunil Kumar; Moosan, Hisham

doi:10.4103/2212-5531.201900

Cited by 7 publications

(3 citation statements)

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“…There are concerns both about false-negative and false-positive Xpert MTB/RIF test results, and a policy of confirmatory testing has been introduced in South Africa and Brazil 28,29 . The discordant DST results that potentially led to under treatment of drug-resistant tuberculosis (false negative for resistance) were mainly based on locally performed cultures, Xpert MTB/RIF tests, or a combination of the two.…”

Section: Discussionmentioning

confidence: 99%

Drug susceptibility testing and mortality in patients treated for tuberculosis in high-burden countries: a multicentre cohort study

Carter

Böttger

Zürcher

et al. 2019

The Lancet Infectious Diseases

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Background: Drug resistance is a challenge for the global control of tuberculosis. We examined mortality in tuberculosis patients from high-burden countries, according to concordance or discordance of results from drug susceptibility testing (DST) done locally and in a reference laboratory. Methods: We collected Mycobacterium tuberculosis isolates from adult patients in Côte d’Ivoire, Democratic Republic of the Congo, Kenya, Nigeria, South Africa, Peru, and Thailand, stratified by HIV status and tuberculosis drug resistance. Molecular or phenotypic drug susceptibility testing (DST) was done locally and at the Swiss tuberculosis reference laboratory. We examined mortality during treatment according to DST results and treatment adequacy in logistic regression models adjusting for sex, age, sputum microscopy and HIV status. Findings: 634 tuberculosis patients were included; median age was 33.2 years, 239 (37.7%) were female, 272 (42.9%) HIV-positive and 69 (10.9%) patients died. Based on the reference laboratory DST, 394 (62.2%) strains were pan-susceptible, 45 (7.1%) mono-resistant, 163 (25.7%) multidrug-resistant (MDR-TB), and 30 (4.7%) had pre-extensive or extensive drug resistance (pre-XDR/XDR-TB). Results of reference and local laboratories were discordant in 121 (19.1%) cases. Overall, sensitivity and specificity to detect any resistance were 90.8% and 84.3%, respectively. Mortality ranged from 6.0% (20/336) in patients with pan-susceptible tuberculosis treated according to WHO guidelines to 57.1% (8/14) in patients with resistant strains who were under treated. In logistic regression, compared to concordant DST results, the adjusted odds ratio of death was 7.33 (95% CI 2.70–19.95) for patients with discordant results potentially leading to under treatment. Interpretation: Inaccurate DST by comparison to a reference standard led to under treatment of drug resistant tuberculosis and increased mortality. Rapid molecular DST of first- and second-line drugs at diagnosis is required to improve outcomes in patients with MDR-TB and pre-XDR/XDR-TB.

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Section: Discussionmentioning

confidence: 99%

Drug susceptibility testing and mortality in patients treated for tuberculosis in high-burden countries: a multicentre cohort study

Carter

Böttger

Zürcher

et al. 2019

The Lancet Infectious Diseases

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“…There are concerns both about false-negative and false-positive Xpert MTB/RIF test results, and a policy of confirmatory testing has been introduced in South Africa and Brazil [27,28]. The discordant DST results that potentially led to under treatment of drug-resistant tuberculosis (false negative for resistance) were mainly based on locally performed cultures, Xpert MTB/RIF tests, or a combination of the two.…”

Section: Discussionmentioning

confidence: 99%

Drug susceptibility testing and mortality in patients treated for tuberculosis in high-burden countries

Zuercher

Ballif

Fenner

et al. 2018

Preprint

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. CC-BY 4.0 International license It is made available under a (which was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint . http://dx.doi.org/10.1101/370056 doi: bioRxiv preprint first posted online Jul. 18, 2018; 3 ABSTRACT Background: Drug resistance and HIV co-infection are challenges for the global control

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“…They can also be used to assess disease intensity levels, as well as for diagnosing complications related with tuberculosis. [15][16][17][18] Whole genome sequencing (WGS), loop mediated isothermal amplification, breath tests for volatile organic compounds and urine assay for lipoarabinomannan are all new methods that can increase the accuracy of TB diagnosis; also improve its accessibility. These cuttingedge technologies also have the potential of point-of-care testing, increased sensitivity in certain groups (children or immunocompromised patients), and even direct drug resistance patterns observed from clinical specimens.…”

Section: Tuberculosis Diagnosticsmentioning

confidence: 99%

Recent advances in tuberculosis: A comprehensive review of emerging trends in pathogenesis, diagnostics, treatment, and prevention

Salim Al-Karawi,

Kadhim,

Kadum

2024

IJCBR

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It is an in-depth analysis of a globally significant infectious disease, tuberculosis (TB). It covers the epidemiology, pathogenesis, diagnosis, treatment and prevention of TB with attention to its successes and shortcomings. The review examines this complicated relationship between Mycobacterium tuberculosis and the human host. It describes how outcomes move from latent infection to active disease. An Overview It introduces the current diagnostic methods, therapeutic regimens and preventive strategies; repeated emphasis is placed on targeted interventions and public health efforts. Also, the review covers future efforts in TB research and control that will further improve prevention and treatment. These include vaccines; new drugs (including a quest for novel agents); improved diagnostics (such as more rapid tests or smear-free methods); public health interventions such as policies on occupational exposures to respiratory rusts; integrated care models including continuity of services between Through these points the review illuminates how much can still be accomplished in terms of controlling--and even eliminating entirely--TB, with ramifications for global public health.

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Are WHO approved nucleic acid amplification tests causing large-scale “false identification” of rifampicin-resistant tuberculosis?: Programmatic experience from south india

Cited by 7 publications

References 0 publications

Drug susceptibility testing and mortality in patients treated for tuberculosis in high-burden countries: a multicentre cohort study

Drug susceptibility testing and mortality in patients treated for tuberculosis in high-burden countries: a multicentre cohort study

Drug susceptibility testing and mortality in patients treated for tuberculosis in high-burden countries

Recent advances in tuberculosis: A comprehensive review of emerging trends in pathogenesis, diagnostics, treatment, and prevention

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