Analysis of rifampicin resistance in Mycobacterium tuberculosis determined by Xpert MTB/RIF and phenotypic drug susceptibility test

doi:10.3969/j.issn.1673-8640.2023.11.005

Abstract

Abstract:

Objective To investigate the consistency between the results of Xpert MTB/RIF and phenotypic drug susceptibility test（pDST） determining rifampicin（RFP） resistance in Mycobacterium tuberculosis（MTB） and the cause of inconsistent results. Methods A total of 672 MTB isolates determined by Xpert MTB/RIF in Yunnan 2020 were determined by pDST，and the whole genome sequencing（WGS） was performed for the isolates with inconsistent results. Results With pDST as the gold standard，the sensitivity and specificity of Xpert MTB/RIF for MTB with RFP resistance were 94.44% and 97.32%，respectively. The positive predictive value was 66.67%，and the negative predictive value was 99.52%. Xpert MTB/RIF was inconsistent with pDST for MTB with RFP resistance in 19 isolates（2.83%）. The 2 isolates of Xpert MTB/RIF showed sensitive to RFP，pDST showed resistant，no mutation in 1 isolate and rpoB-Ile491Phe mutation in 1 isolate. RFP resistance-related mutations were found in the 17 isolates of Xpert MTB/RIF showed resistant to RFP，and pDST showed sensitive. No significant hetero-resistance was found. Conclusions Xpert MTB/RIF has good consistency with pDST for MTB with RFP resistance. The main reasons for inconsistent results are the instability of pDST results，the poor correlation between some rpoB gene mutations and RFP resistance and the occurrence of other mutations other than Xpert MTB/RIF targets in a few isolates.

Key words: Mycobacterium tuberculosis, Xpert MTB/RIF, Phenotypic drug susceptibility test, Rifampicin, Drug resistance

CLC Number:

R378.91

RU Haohao, CHEN Lianyong, YANG Xing, CHEN Tao, YAN Shuangqun, XU Lin. Analysis of rifampicin resistance in Mycobacterium tuberculosis determined by Xpert MTB/RIF and phenotypic drug susceptibility test[J]. Laboratory Medicine, 2023, 38(11): 1032-1035.

Figures/Tables 2

References 13

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