AI Article Synopsis
- A study was conducted on clinical isolates with conflicting results from phenotypic and genotypic tests for rifampin resistance in TB at the Tijuana General Hospital in Mexico.
- Out of 13 isolates tested, discrepancies were found where some were classified as rifampin-susceptible yet resistant according to another test, with DNA sequencing revealing various mutations in some isolates.
- The findings highlighted the importance of further DNA sequencing for accurate diagnoses of rifampin resistance, especially due to cases of heteroresistance and silent mutations.
Article Abstract
Clinical isolates with discordant phenotypic and genotypic results were submitted to DNA sequencing to identify which were genuinely resistant to rifampin and determine the frequency of silent and disputed mutations in our region. We present the retrospective analysis of all the culture-proven TB cases tested with the Xpert®MTB/RIF assay at the Tuberculosis Clinic and Laboratory of the Tijuana General Hospital, Mexico. Clinical isolates showing a discrepancy between phenotypic and molecular tests were analyzed by DNA sequencing. Thirteen isolates tested as rifampin susceptible on the MGIT system were rifampin-resistant according to Xpert®MTB/RIF assay. DNA sequencing showed that seven (53.8%) isolates had a silent (P514P) mutation; three isolates showed different missense (L511P, D516Y, and S531L) mutations. Three isolates showed no mutations. The existence of heteroresistance and silent or disputed mutations warrants that all rifampin-resistance cases diagnosed with the Xpert®MTB/RIF should be referred to specialized centers for DNA sequencing.
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| http://dx.doi.org/10.1016/j.meegid.2021.105142 | DOI Listing |
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