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Int J Tuberc Lung Dis. 2014 Oct;18(10):1255-7. doi: 10.5588/ijtld.14.0297.

False-positive rifampicin resistance on Xpert® MTB/RIF caused by a silent mutation in the rpoB gene.

Author information

1
National Reference Centre of Tuberculosis and Mycobacteria, Communicable and Infectious Diseases, Scientific Institute of Public Health, Brussels, Belgium.
2
Department of Microbiology, Ziekenhuis Netwerk Antwerpen (ZNA) Stuivenberg, Antwerp, Belgium.
3
Department of Pneumology, ZNA Middelheim, Antwerp, Belgium.
4
Belgian Lung and Tuberculosis Association, Brussels, Belgium.

Abstract

The Xpert® MTB/RIF assay detects the presence of Mycobacterium tuberculosis and its resistance to rifampicin (RMP) directly in sputum samples. Discrepant results were observed in a case of smear-positive pulmonary tuberculosis that was Xpert-resistant but phenotypically susceptible to RMP. Complementary investigations (repeat Xpert, Genotype®MTBDRplus assay and sequencing of the rpoB gene) revealed the presence of a silent mutation in the rpoB gene, leading to the conclusion of a false-positive Xpert result. As misinterpretation of Xpert results may lead to inappropriate treatment, the presence of rpoB mutations should be confirmed by sequencing the rpoB gene.

PMID:
25216843
DOI:
10.5588/ijtld.14.0297
[Indexed for MEDLINE]

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