Rise in rifampicin-monoresistant tuberculosis in Western Cape, South Africa

Mukinda, Fidele Kanyimbu; Theron, Danie; Spuy, Gian D. van der; Jacobson, Karen R; Roscher, M.; Streicher, Elizabeth M.; Musekiwa, Alfred; Coetzee, Gerrit; Victor, Thomas C.; Marais, Ben J.; Nachega, Jean B.; Warren, Robin M.; Schaaf, H. Simon

doi:10.5588/ijtld.11.0116

Cited by 66 publications

(61 citation statements)

References 17 publications

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“…More recently, an additional risk factor (excessive alcohol use) has been reported in surveys for Brazil, South Africa, Burundi, and Russia. [30][31][32][33] In the present study, 33.6% of RMR patients had a history of TB or had close contact with a known TB patient. This rate reached 58% in immigrants.…”

Section: Discussionmentioning

confidence: 99%

High Prevelance of Rifampin-Monoresistant Tuberculosis: A Retrospective Analysis among Iranian Pulmonary Tuberculosis Patients

Velayati

Farnia²,

Mozafari³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. We determined the prevalence of rifampin-monoresistant tuberculosis (RMR-TB) in Iran. Because development of RMR-TB is not common, we also identified the major risk factors associated with RMR-TB reported from different provinces of Iran. Data for 3,020 TB patients who remained or became smear positive after two, four, six, and nine months of standard first-line chemotherapy were retrospectively analyzed. Of 3,020 patients, 1,242 patients (41.1%) were culture and DNA positive for Mycobacterium tuberculosis. Of these patients, 73 (7.4%) patients had monoresistant isolates to rifampin, which was significantly higher than that for multidrug-resistant TB (5.8%). The average rate of RMR-TB in the studied population ranged from 5% to 10%. Classical investigation showed that 33.6% of patients had either a previous or family history of TB. Molecular epidemiology methods (i.e., spoligotyping and Mycobacterium intespersed repetitive unit-variable number tandem repeat), defined transmission link in three clusters (13%). These results outline the urgent need for a comprehensive plan for detection and treatment of RMR-TB cases.

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Section: Discussionmentioning

confidence: 99%

High Prevelance of Rifampin-Monoresistant Tuberculosis: A Retrospective Analysis among Iranian Pulmonary Tuberculosis Patients

Velayati

Farnia²,

Mozafari³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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“…The incidence of MDR-TB in Italy is low but has increased in recent years, possibly because of increased immigration from developing countries (22). It is well known that more than 90% of RIF resistance is associated with INH resistance (23); for this reason, RIF resistance is widely used by other commercial tests, such as the GeneXpert MTB/RIF assay, as a surrogate marker for MDR-TB (23). It was shown that a number of false-positive results for RIF resistance were detected with those assays, however, and the consequences were discussed from clinical and public health perspectives (24).…”

Section: Discussionmentioning

confidence: 99%

Multicenter Evaluation of Anyplex Plus MTB/NTM MDR-TB Assay for Rapid Detection of Mycobacterium tuberculosis Complex and Multidrug-Resistant Isolates in Pulmonary and Extrapulmonary Specimens

et al. 2016

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The rapid diagnosis of tuberculosis (TB) and the detection of drug-resistant Mycobacterium tuberculosis strains are critical for successful public health interventions. Therefore, TB diagnosis requires the availability of diagnostic tools that allow the rapid detection of M. tuberculosis and drug resistance in clinical samples. Here, we performed a multicenter study to evaluate the performance of the Seegene Anyplex MTB/NTM MDR-TB assay, a new molecular method based on a multiplex real-time PCR system, for detection of Mycobacterium tuberculosis complex (MTBC), nontuberculous mycobacteria (NTM), and genetic determinants of drug resistance. In total, the results for 755 samples (534 pulmonary and 221 extrapulmonary samples) were compared with the results of smears and cultures. For pulmonary specimens, the sensitivities of the Anyplex assay and acid-fast bacillus smear testing were 86.4% and 75.0%, respectively, and the specificities were 99% and 99.4%. For extrapulmonary specimens, the sensitivities of the Anyplex assay and acid-fast bacillus smear testing were 83.3% and 50.0%, respectively, and the specificities of both were 100%. The negative and positive predictive values of the Anyplex assay for pulmonary specimens were 97% and 100%, respectively, and those for extrapulmonary specimens were 84.6% and 100%. The sensitivities of the Anyplex assay for detecting isoniazid resistance in MTBC strains from pulmonary and extrapulmonary specimens were 83.3% and 50%, respectively, while the specificities were 100% for both specimen types. These results demonstrate that the Anyplex MTB/NTM MDR-TB assay is an efficient and rapid method for the diagnosis of pulmonary and extrapulmonary TB and the detection of isoniazid resistance.

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“…Of the 285 smear-positive samples which were subjected to the LPA test, 41.5% were found susceptible to INH and RIF, while 22.2% samples showed RIF monoresistance, which can be expected in a high-TB-burden country like India (8,13). Much lower RIF monoresistance levels were reported from another high-TB-burden country (South Africa [13.5%]) and a low-TB-burden country (United States [13%]) (22,23). In the present study, high RIF resistance could be due to the fact that most of the samples were received from relapse cases, which were on category II treatment for more than 2 months.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Xpert MTB/RIF with Line Probe Assay for Detection of Rifampin-Monoresistant Mycobacterium tuberculosis

et al. 2014

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The MTBDRplus line probe assay (LPA) and Xpert MTB/RIF have been endorsed by the World Health Organization for the rapid diagnosis of drug-resistant tuberculosis. However, there is no clarity regarding the superiority of one over the other. In a double-blinded prospective study, we evaluated the efficacy of the Xpert MTB/RIF on samples that were first tested by LPA under the revised national tuberculosis control program of India. A total of 405 sputum samples from suspected drug-resistant tuberculosis patients were included. Of these, 285 smear-positive samples were subjected to LPA. Seventy-two (25.8%) samples showed multidrug resistance, 62 (22.2%) showed rifampin monoresistance, 29 (10.3%) showed isoniazid monoresistance, and 116 (41.5%) were pan-susceptible. Six (2.1%) of the samples gave invalid results. Of the 62 rifampin-monoresistant samples by LPA, 38 (61.4%) showed rifampin resistance, while 21 (33.8%) were found susceptible to rifampin by Xpert MTB/RIF using cartridge version G4. Three (4.8%) samples gave an error. Of the 116 pan-susceptible samples, only 83 were available for Xpert MTB/RIF testing; 4 (5.1%) were rifampin resistant, 74 (94.8%) were susceptible, and 5 (6.0%) showed an error. The 25 discrepant samples were further subjected to MGIT960 drug susceptibility testing. The MGIT960 results showed 100% agreement with LPA results but only 64.4% agreement with Xpert MTB/RIF results. Sequencing analysis of discrepant samples showed 91.3% concordance with LPA but only 8.7% concordance with the Xpert MTB/RIF assay. These findings indicate that by using Xpert MTB/RIF testing we might be underestimating the burden of drug-resistant tuberculosis and indicate that country-specific probes need to be designed to increase the sensitivity of the Xpert MTB/RIF. T he global burden of tuberculosis (TB), particularly with multidrug resistance (MDR), is increasing and has become a major health challenge (1). The disease caused by Mycobacterium tuberculosis resistant to two primary antitubercular drugs, rifampin (RIF) and isoniazid (INH), is known as MDR-TB. Such instances are more common among clinical relapse cases (2). It has been reported that M. tuberculosis that is resistant to RIF is more likely to have concomitant resistance to INH, making RIF resistance a surrogate marker of MDR-TB (3). Early diagnosis of TB and rapid detection of RIF resistance is important for proper management of drug-resistant TB (DR-TB) (4). But in spite of major efforts that are being done to increase case detection, one-third of new TB cases are still missed due to nonavailability of rapid, low-cost, and accurate diagnostic facilities in high-TB-burden countries (5).Over the last 6 years, efforts have been made to improve and develop rapid diagnostic tools and drug susceptibility testing (DST) for TB. During this period, the World Health Organization (WHO) had issued 10 policy statements for improving diagnosis of TB, including the use of commercial and noncommercial DST methods and implementation of molecular methods such as the ...

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Rise in rifampicin-monoresistant tuberculosis in Western Cape, South Africa

Cited by 66 publications

References 17 publications

High Prevelance of Rifampin-Monoresistant Tuberculosis: A Retrospective Analysis among Iranian Pulmonary Tuberculosis Patients

High Prevelance of Rifampin-Monoresistant Tuberculosis: A Retrospective Analysis among Iranian Pulmonary Tuberculosis Patients

Multicenter Evaluation of Anyplex Plus MTB/NTM MDR-TB Assay for Rapid Detection of Mycobacterium tuberculosis Complex and Multidrug-Resistant Isolates in Pulmonary and Extrapulmonary Specimens

Comparison of Xpert MTB/RIF with Line Probe Assay for Detection of Rifampin-Monoresistant Mycobacterium tuberculosis

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