Advanced search
Start date
Betweenand
Related content
(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Xpert MTB/RIF performance to diagnose tuberculosis and rifampicin resistance in a reference centre in southern Brazil

Full text
Author(s):
Feliciano, Cinara Silva [1] ; Bazzo Menon, Lucas Jose [1] ; Pala Anselmo, Livia Maria [1] ; Dippenaar, Anzaan [2] ; Warren, Robin Mark [2] ; Silva, Jr., Wilson Araujo [3, 4] ; Bollela, Valdes Roberto [1]
Total Authors: 7
Affiliation:
[1] Univ Sao Paulo FMRP USP, Ribeirao Preto Med Sch, Dept Internal Med, Sao Paulo - Brazil
[2] Stellenbosch Univ, DST NRF Ctr Excellence Biomed TB Res, SAMRC Ctr TB Res, Div Mol Biol & Human Genet, Fac Med & Hlth Sci, Stellenbosch - South Africa
[3] FMRP USP, Ctr Med Genom, Clin Hosp Ribeirao Preto Med Sch, Sao Paulo - Brazil
[4] FMRP USP, Ribeirao Preto Med Sch, Dept Genet, Sao Paulo - Brazil
Total Affiliations: 4
Document type: Journal article
Source: ERJ OPEN RESEARCH; v. 5, n. 3 JUL 1 2019.
Web of Science Citations: 1
Abstract

Effective treatment of tuberculosis (TB) remains a serious public health problem in many countries, including Brazil, especially when considering drug-resistant disease. Xpert MTB/RIF has been implemented in many countries to reduce the time to TB diagnosis and to rapidly detect rifampicin resistance. The study aimed to describe and evaluate Xpert MTB/RIF performance in diagnosing pulmonary TB and rifampicin resistance in a tertiary healthcare facility in Brazil. A cross-sectional study was performed, which included all isolates of confirmed pulmonary TB patients from 2015 to 2018. Both Xpert MTB/RIF and GenoType MTBDRplus assays were performed to detect rifampicin and isoniazid resistance. In addition, isolates with detected resistance to rifampicin and/or isoniazid were analysed by phenotypic testing using MGIT-960 SIRE kit and whole-genome sequencing (WGS) using Illumina MiSeq Sequencing System. 2148 respiratory specimens tested with Xpert MTB/RIF were included: n=1556 sputum, n=348 bronchoalveolar lavage and n=244 gastric washing. The overall Xpert MTB/RIF sensitivity in sputum was 94% and the overall specificity was 98%. The negative predictive value in sputum of all the patients was 99% with a positive predictive value of 89%. The concordance between Xpert MTB/RIF and phenotypic susceptibility test was 94.1%, while its concordance with WGS was 78.9%. Xpert MTB/RIF is a rapid and accurate diagnostic strategy for pulmonary TB, which can contribute to improvement in TB control. However, detection of rifampicin resistance might be associated with false-positive results. (AU)

FAPESP's process: 15/13333-3 - Molecular epidemiology of multidrug resistant tuberculosis through whole genome sequencing
Grantee:Valdes Roberto Bollela
Support Opportunities: Regular Research Grants