False-positive rifampicin resistance on Xpert® MTB/RIF caused by a silent mutation in the rpoB gene.
van de Vyvere, M de Droogh, E Groenen, G
van de Vyvere, M
de Droogh, E
Groenen, G
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Abstract
The Xpert® MTB/RIF assay detects the presence of Mycobacterium tuberculosis and its resistance to rifampicin (RMP) directly in sputum samples. Discrepant results were observed in a case of smear-positive pulmonary tuberculosis that was Xpert-resistant but phenotypically susceptible to RMP. Complementary investigations (repeat Xpert, Genotype®MTBDRplus assay and sequencing of the rpoB gene) revealed the presence of a silent mutation in the rpoB gene, leading to the conclusion of a false-positive Xpert result. As misinterpretation of Xpert results may lead to inappropriate treatment, the presence of rpoB mutations should be confirmed by sequencing the rpoB gene.
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2014-10-01
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Peer reviewed scientific article
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Aged, Amikacin, Amino Acid Sequence, Antibiotics, Antitubercular, Bacterial Proteins, DNA-Directed RNA Polymerases, Drug Resistance, Multiple, Bacterial, Ethambutol, Ethionamide, Fluoroquinolones, Genotype, Humans, Isoniazid, Male, Molecular Sequence Data, Mutation, Mycobacterium tuberculosis, Phenotype, Pyrazinamide, Rifampin, Sensitivity and Specificity, sputum, Tuberculosis, Pulmonary