Tuberculosis Variant with Rifampin Resistance Undetectable by Xpert MTB/RIF, Botswana

Abstract

GeneXpert MTB/RIF, a tool widely used for diagnosing tuberculosis, has limitations for detecting rifampin resistance in certain variants. We report transmission of a pre–extensively drug-resistant variant in Botswana that went undetected by GeneXpert. The public health impact of misdiagnosis emphasizes the need for comprehensive molecular testing to identify resistance and guide treatment.

Keywords

• multidrug-resistant tuberculosis
• tuberculosis and other mycobacteria
• pre–XDR TB
• antimicrobial resistance
• whole-genome sequencing
• molecular diagnostics