Prevalence and causes of rifampicin-resistance genotypic/phenotypic discrepancy detected on Xpert MTB/RIF in Singapore
The Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) (Cepheid, Sunnyvale, CA, US) has been pivotal in tuberculosis (TB) diagnostics, enabling the rapid detection of both TB and RIF resistance. Xpert, a nucleic acid amplification test (NAAT), is recommended by both the World Health Organization...
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Academy of Medicine Singapore
2024-12-01
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| Series: | Annals, Academy of Medicine, Singapore |
| Online Access: | https://annals.edu.sg/prevalence-and-causes-of-rifampicin-resistance-genotypic-phenotypic-discrepancy-detected-on-xpert-mtb-rif-in-singapore/ |
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| author | Caroline Victoria Choong Lovel Galamay Jerlyn Huixian Woo Angeline Jie-Yin Tey Cynthia Bin Eng Chee |
| author_facet | Caroline Victoria Choong Lovel Galamay Jerlyn Huixian Woo Angeline Jie-Yin Tey Cynthia Bin Eng Chee |
| author_sort | Caroline Victoria Choong |
| collection | DOAJ |
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The Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) (Cepheid, Sunnyvale, CA, US) has been pivotal in tuberculosis (TB) diagnostics, enabling the rapid detection of both TB and RIF resistance. Xpert, a nucleic acid amplification test (NAAT), is recommended by both the World Health Organization (WHO)1 and Singapore’s clinical management guidelines2 as a frontline diagnostic tool for TB and RIF resistance. With a high specificity rate (98%) in detecting RIF resistance, Xpert has a positive predictive value (PPV) exceeding 90% in settings where the prevalence of RIF resistance is above 15%.3 However, in Singapore, a country with medium-incidence of TB and low prevalence of RIF resistance (<1% among individuals born in Singapore), 4 the PPV of detecting RIF resistance via Xpert is substantially lower.3 Phenotypic-genotypic discrepant RIF resistance have been reported to result from technical errors, false-positive results in paucibacillary samples,5 silent mutations6 or disputed mutations where minimal inhibitory concentrations (MICs) fall below critical concentrations in phenotypic drug susceptibility testing (pDST) systems.7 We conducted a quality assessment of sputum samples which tested positive for TB and RIF resistance using point-of-care Xpert at the Singapore National Tuberculosis Care Centre (NTBCC) to determine the prevalence and causes of false-positive RIF resistance. |
| format | Article |
| id | doaj-art-538a71f08dad4c8abe70d4782521f470 |
| institution | Kabale University |
| issn | 2972-4066 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Academy of Medicine Singapore |
| record_format | Article |
| series | Annals, Academy of Medicine, Singapore |
| spelling | doaj-art-538a71f08dad4c8abe70d4782521f4702025-01-13T02:33:24ZengAcademy of Medicine SingaporeAnnals, Academy of Medicine, Singapore2972-40662024-12-01531276576710.47102/annals-acadmedsg.2024271Prevalence and causes of rifampicin-resistance genotypic/phenotypic discrepancy detected on Xpert MTB/RIF in SingaporeCaroline Victoria ChoongLovel GalamayJerlyn Huixian WooAngeline Jie-Yin TeyCynthia Bin Eng Chee The Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) (Cepheid, Sunnyvale, CA, US) has been pivotal in tuberculosis (TB) diagnostics, enabling the rapid detection of both TB and RIF resistance. Xpert, a nucleic acid amplification test (NAAT), is recommended by both the World Health Organization (WHO)1 and Singapore’s clinical management guidelines2 as a frontline diagnostic tool for TB and RIF resistance. With a high specificity rate (98%) in detecting RIF resistance, Xpert has a positive predictive value (PPV) exceeding 90% in settings where the prevalence of RIF resistance is above 15%.3 However, in Singapore, a country with medium-incidence of TB and low prevalence of RIF resistance (<1% among individuals born in Singapore), 4 the PPV of detecting RIF resistance via Xpert is substantially lower.3 Phenotypic-genotypic discrepant RIF resistance have been reported to result from technical errors, false-positive results in paucibacillary samples,5 silent mutations6 or disputed mutations where minimal inhibitory concentrations (MICs) fall below critical concentrations in phenotypic drug susceptibility testing (pDST) systems.7 We conducted a quality assessment of sputum samples which tested positive for TB and RIF resistance using point-of-care Xpert at the Singapore National Tuberculosis Care Centre (NTBCC) to determine the prevalence and causes of false-positive RIF resistance.https://annals.edu.sg/prevalence-and-causes-of-rifampicin-resistance-genotypic-phenotypic-discrepancy-detected-on-xpert-mtb-rif-in-singapore/ |
| spellingShingle | Caroline Victoria Choong Lovel Galamay Jerlyn Huixian Woo Angeline Jie-Yin Tey Cynthia Bin Eng Chee Prevalence and causes of rifampicin-resistance genotypic/phenotypic discrepancy detected on Xpert MTB/RIF in Singapore Annals, Academy of Medicine, Singapore |
| title | Prevalence and causes of rifampicin-resistance genotypic/phenotypic discrepancy detected on Xpert MTB/RIF in Singapore |
| title_full | Prevalence and causes of rifampicin-resistance genotypic/phenotypic discrepancy detected on Xpert MTB/RIF in Singapore |
| title_fullStr | Prevalence and causes of rifampicin-resistance genotypic/phenotypic discrepancy detected on Xpert MTB/RIF in Singapore |
| title_full_unstemmed | Prevalence and causes of rifampicin-resistance genotypic/phenotypic discrepancy detected on Xpert MTB/RIF in Singapore |
| title_short | Prevalence and causes of rifampicin-resistance genotypic/phenotypic discrepancy detected on Xpert MTB/RIF in Singapore |
| title_sort | prevalence and causes of rifampicin resistance genotypic phenotypic discrepancy detected on xpert mtb rif in singapore |
| url | https://annals.edu.sg/prevalence-and-causes-of-rifampicin-resistance-genotypic-phenotypic-discrepancy-detected-on-xpert-mtb-rif-in-singapore/ |
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