MEM INST OSWALDO CRUZ, RIO DE JANEIRO, Vol. 112 | 2017
PAGES: DOI: 10.1590/0074-02760170051 Full paper
An evaluation of false-positive rifampicin resistance on the Xpert MTB/RIF

Yeliz Tanriverdi Cayci1, Kemal Bilgin2, Ahmet Yilmaz Coban1,+, Asuman Birinci1, Belma Durupınar1

1Ondokuz Mayis University, Medical Faculty, Department of Medical Microbiology, Samsun, Turkey
2Ondokuz Mayis University, Vocational School of Health Services, Department of Medical Services and Techniques, Samsun, Turkey

Abstract

BACKGROUND Mycobacterium tuberculosis (MTB) is one of the most significant causes of mortality and morbidity. Early diagnose is important especially in multiple drug resistant tuberculosis to avoid transmission. Traditional techniques requires at least one to three weeks for diagnosis of tuberculosis. Diagnostic delays with multiple drug resistant tuberculosis are associated with worse clinical outcomes and increased transmission The Xpert MTB/RIF assay is one of the new diagnostic device for the diagnosis of tuberculosis and rapid detection of rifampicin resistance.

OBJECTIVE We assessed the performance of Xpert MTB/RIF assay for detecting rifampicin resistance using phenotypic drug susceptibility tests as automated BD MGIT 960.

METHODS Total of 2136 specimens were included in the study. Xpert MTB/RIF testing was performed on samples, using version 4 cartridges, according to the manufacturer’s recommendations. The MTBC culture and first-line phenotypic DST were performed in automated BD MGIT 960 (Becton & Dickinson, USA) according to the recommendations of the manufacturer. Agar proportion was used in the case of inconsistency for rifampicin resistance.

FINDINGS Thirty-four samples (19 respiratory and 15 nonrespiratory samples) were determined as positive for M. tuberculosis complex by Xpert MTB/RIF (Cepheid GeneXpert® System, USA). Xpert MTB/RIF assay detected 4/34 (11.7%) specimens as rifampicin resistant. One of the rifampicin resistant isolates was determined susceptible in MGIT 960 automated system. This isolate was also tested with agar proportion method and found susceptible to rifampicin.

MAIN CONCLUSION The Xpert MTB/RIF assay can be used as first-line assay for the detection of M. tuberculosis. However, microbiologists must be aware of the limitations of the assay.

+ Corresponding author: This e-mail address is being protected from spambots. You need JavaScript enabled to view it.
Received 6 February 2017
Accepted 7 July 2017

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