Phenotypic drug susceptibility characterization and clinical outcomes of tuberculosis strains with A-probe mutation by GeneXpert MTB/RIF
Abstract Background GeneXpert MTB/RIF (Xpert) assay was applied widely to detect Mycobacterium tuberculosis (MTB) and rifampicin resistance. Methods Retrospectively investigated the association among treatment histories, phenotypic drug susceptibility testing (pDST) results, and clinical outcomes of...
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| Format: | Article |
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BMC
2023-11-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-023-08509-0 |
| _version_ | 1797415906401320960 |
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| author | Qi Nie Dan Sun Muxin Zhu Shengjin Tu Nanshan Chen Hua Chen Yong Zhou Ge Yao Xiaoqing Zhang Tongcun Zhang Chengfeng Yang Lixuan Tao |
| author_facet | Qi Nie Dan Sun Muxin Zhu Shengjin Tu Nanshan Chen Hua Chen Yong Zhou Ge Yao Xiaoqing Zhang Tongcun Zhang Chengfeng Yang Lixuan Tao |
| author_sort | Qi Nie |
| collection | DOAJ |
| description | Abstract Background GeneXpert MTB/RIF (Xpert) assay was applied widely to detect Mycobacterium tuberculosis (MTB) and rifampicin resistance. Methods Retrospectively investigated the association among treatment histories, phenotypic drug susceptibility testing (pDST) results, and clinical outcomes of patients infected with probe A absent mutation isolate confirmed by Xpert. Results 63 patients with only probe A absent mutation and 40 with additional pDST results were analyzed. 24 (60.0%) patients had molecular-phenotypic discordant rifampicin (RIF) susceptibility testing results, including 12 (12/13, 92.3%) new tuberculosis (TB) patients and 12 (12/27, 44.4%) retreated ones. 28 (28/39, 71.8%) retreated patients received first-line treatment regime within two years with failed outcomes. New patients had better treatment outcomes than retreated ones (successful: 83.3% VS. 53.8%; P value = 0.02). The clinical results of RIF-susceptible TB confirmed by pDST were not better than RIF-resistant TB (successful: 62.5% VS. 50.0%; P value = 0.43). INH-resistant TB and INH-susceptible TB had similar treatment outcomes too (successful: 61.5% VS. 50.0%; P value = 0.48). 11 (11/12, 91.7%) new patients treated with the short treatment regimen (STR) had successful outcomes. Conclusions More than half of mono probe A absent isolates had RIF molecular-phenotypic discordance results, especially in new patients. Probe A mutations were significantly associated with unsuccessful clinical outcomes, whether the pDST results were RIF susceptible or not. STR was the best choice for new patients. Trial registration retrospectively registered in Wuhan Jinyintan Hospital (No. 2021-KY-16). |
| first_indexed | 2024-03-09T05:56:12Z |
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| id | doaj.art-5ccb3ed61b51433991f2800ad81162e4 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-09T05:56:12Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-5ccb3ed61b51433991f2800ad81162e42023-12-03T12:13:25ZengBMCBMC Infectious Diseases1471-23342023-11-012311910.1186/s12879-023-08509-0Phenotypic drug susceptibility characterization and clinical outcomes of tuberculosis strains with A-probe mutation by GeneXpert MTB/RIFQi Nie0Dan Sun1Muxin Zhu2Shengjin Tu3Nanshan Chen4Hua Chen5Yong Zhou6Ge Yao7Xiaoqing Zhang8Tongcun Zhang9Chengfeng Yang10Lixuan Tao11College of Life Sciences and Health, Wuhan University of Science and TechnologyDepartment of Interventional therapy, Wuhan Pulmonary HospitalDepartment of MDR/RR-TB, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, University of Science and Technology, Hubei Clinical Research Center for Infectious Diseases, Chinese Academy of Medical SciencesDepartment of MDR/RR-TB, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, University of Science and Technology, Hubei Clinical Research Center for Infectious Diseases, Chinese Academy of Medical SciencesDepartment of MDR/RR-TB, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, University of Science and Technology, Hubei Clinical Research Center for Infectious Diseases, Chinese Academy of Medical SciencesDepartment of MDR/RR-TB, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, University of Science and Technology, Hubei Clinical Research Center for Infectious Diseases, Chinese Academy of Medical SciencesDepartment of MDR/RR-TB, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, University of Science and Technology, Hubei Clinical Research Center for Infectious Diseases, Chinese Academy of Medical SciencesDepartment of MDR/RR-TB, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, University of Science and Technology, Hubei Clinical Research Center for Infectious Diseases, Chinese Academy of Medical SciencesDepartment of MDR/RR-TB, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong, Wuhan Research Center for Communicable Disease Diagnosis and Treatment, University of Science and Technology, Hubei Clinical Research Center for Infectious Diseases, Chinese Academy of Medical SciencesCollege of Life Sciences and Health, Wuhan University of Science and TechnologyHubei Provincial Center for Disease Control and PreventionEmergency Department, Puren Hospital, Wuhan University of science and technologyAbstract Background GeneXpert MTB/RIF (Xpert) assay was applied widely to detect Mycobacterium tuberculosis (MTB) and rifampicin resistance. Methods Retrospectively investigated the association among treatment histories, phenotypic drug susceptibility testing (pDST) results, and clinical outcomes of patients infected with probe A absent mutation isolate confirmed by Xpert. Results 63 patients with only probe A absent mutation and 40 with additional pDST results were analyzed. 24 (60.0%) patients had molecular-phenotypic discordant rifampicin (RIF) susceptibility testing results, including 12 (12/13, 92.3%) new tuberculosis (TB) patients and 12 (12/27, 44.4%) retreated ones. 28 (28/39, 71.8%) retreated patients received first-line treatment regime within two years with failed outcomes. New patients had better treatment outcomes than retreated ones (successful: 83.3% VS. 53.8%; P value = 0.02). The clinical results of RIF-susceptible TB confirmed by pDST were not better than RIF-resistant TB (successful: 62.5% VS. 50.0%; P value = 0.43). INH-resistant TB and INH-susceptible TB had similar treatment outcomes too (successful: 61.5% VS. 50.0%; P value = 0.48). 11 (11/12, 91.7%) new patients treated with the short treatment regimen (STR) had successful outcomes. Conclusions More than half of mono probe A absent isolates had RIF molecular-phenotypic discordance results, especially in new patients. Probe A mutations were significantly associated with unsuccessful clinical outcomes, whether the pDST results were RIF susceptible or not. STR was the best choice for new patients. Trial registration retrospectively registered in Wuhan Jinyintan Hospital (No. 2021-KY-16).https://doi.org/10.1186/s12879-023-08509-0Mycobacterium tuberculosisMutationRifampicin-resistantGeneXpert MTB/RIFClinical outcome |
| spellingShingle | Qi Nie Dan Sun Muxin Zhu Shengjin Tu Nanshan Chen Hua Chen Yong Zhou Ge Yao Xiaoqing Zhang Tongcun Zhang Chengfeng Yang Lixuan Tao Phenotypic drug susceptibility characterization and clinical outcomes of tuberculosis strains with A-probe mutation by GeneXpert MTB/RIF BMC Infectious Diseases Mycobacterium tuberculosis Mutation Rifampicin-resistant GeneXpert MTB/RIF Clinical outcome |
| title | Phenotypic drug susceptibility characterization and clinical outcomes of tuberculosis strains with A-probe mutation by GeneXpert MTB/RIF |
| title_full | Phenotypic drug susceptibility characterization and clinical outcomes of tuberculosis strains with A-probe mutation by GeneXpert MTB/RIF |
| title_fullStr | Phenotypic drug susceptibility characterization and clinical outcomes of tuberculosis strains with A-probe mutation by GeneXpert MTB/RIF |
| title_full_unstemmed | Phenotypic drug susceptibility characterization and clinical outcomes of tuberculosis strains with A-probe mutation by GeneXpert MTB/RIF |
| title_short | Phenotypic drug susceptibility characterization and clinical outcomes of tuberculosis strains with A-probe mutation by GeneXpert MTB/RIF |
| title_sort | phenotypic drug susceptibility characterization and clinical outcomes of tuberculosis strains with a probe mutation by genexpert mtb rif |
| topic | Mycobacterium tuberculosis Mutation Rifampicin-resistant GeneXpert MTB/RIF Clinical outcome |
| url | https://doi.org/10.1186/s12879-023-08509-0 |
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