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

Autor(es)

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]

Afiliação do(s) autor(es)

^[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

• Tipo de documento: Artigo Científico
• Fonte: ERJ OPEN RESEARCH; v. 5, n. 3 JUL 1 2019.
• Citações Web of Science: 1

Resumo

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)

• Processo FAPESP: 15/13333-3 - Epidemiologia molecular da tuberculose multirresistente através do sequenciamento genômico
• Beneficiário: Valdes Roberto Bollela
• Modalidade de apoio: Auxílio à Pesquisa - Regular