Rifampicin susceptibility discordance between Xpert MTB/RIF G4 and Xpert Ultra before MDRT-TB treatment initiation: A case report from Uganda

Willy Ssengooba; Kevin Komakech; Sharon Namiiro; Henry Byabajungu; Joanitah Nalunjogi; Winceslaus Katagira; Ivan Kimuli; Moses L Joloba; Susan Adakun; Lydia Nakiyingi; Gabriela Torrea; Bruce J Kirenga

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases (Dec 2021)

Rifampicin susceptibility discordance between Xpert MTB/RIF G4 and Xpert Ultra before MDRT-TB treatment initiation: A case report from Uganda

Willy Ssengooba,
Kevin Komakech,
Sharon Namiiro,
Henry Byabajungu,
Joanitah Nalunjogi,
Winceslaus Katagira,
Ivan Kimuli,
Moses L Joloba,
Susan Adakun,
Lydia Nakiyingi,
Gabriela Torrea,
Bruce J Kirenga

Affiliations

Willy Ssengooba: Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda; Makerere University, Department of Medical Microbiology, Mycobacteriology (BSL-3) Laboratory, P.O.BOX 7072, Kampala, Uganda; Corresponding author at: Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
Kevin Komakech: Makerere University, Department of Medical Microbiology, Mycobacteriology (BSL-3) Laboratory, P.O.BOX 7072, Kampala, Uganda
Sharon Namiiro: Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
Henry Byabajungu: National TB Reference Laboratory, Ministry of Health, Kampala, Uganda
Joanitah Nalunjogi: Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
Winceslaus Katagira: Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
Ivan Kimuli: Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda
Moses L Joloba: Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda; Makerere University, Department of Medical Microbiology, Mycobacteriology (BSL-3) Laboratory, P.O.BOX 7072, Kampala, Uganda
Susan Adakun: Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda; National Tuberculosis Treatment Unit, Mulago Hospital, Kampala, Uganda
Lydia Nakiyingi: Infectious Diseases Institute, Makerere University, Kampala, Uganda
Gabriela Torrea: Unit of Mycobacteriology, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
Bruce J Kirenga: Makerere University Lung Institute, College of Health Sciences, Makerere University, Kampala, Uganda

Journal volume & issue: Vol. 25
p. 100286

Abstract

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Tuberculosis (TB) resistance to rifampicin, the most powerful drug leads to increase in mortality. Globally, half a million new patients develop such resistant TB each year, coupled with both inappropriate diagnosis and treatment initiation.We report a case of rifampicin resistant Mycobacterium tuberculosis whose rifampicin resistance was missed by Xpert MTB/RIF Assay G4 but detected by the Xpert MTB/RIF Ultra assay at different time points leading to increased delays for MDR-TB treatment initiation at Mulago Hospital, Kampala, Uganda. Our case report compels greater urgency in accelerating the transition to the newer assay, Ultra, to benefit from higher sensitivity of rifampicin resistance detection.

Published in Journal of Clinical Tuberculosis and Other Mycobacterial Diseases

ISSN: 2405-5794 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the respiratory system; Medicine: Internal medicine: Infectious and parasitic diseases
Website: https://www.journals.elsevier.com/journal-of-clinical-tuberculosis-and-other-mycobacterial-diseases/

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