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Lung India. 2018 Mar-Apr;35(2):168-170. doi: 10.4103/lungindia.lungindia_71_17.

Pyrosequencing to resolve discrepant Xpert MTB/RIF and Mycobacterial Growth Indicator Tube 960.

Author information

1
Department of Microbiology, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, Maharashtra, India.
2
Johns Hopkins University School of Medicine, Division of Infectious Diseases, Center for Clinical Global Health Education, Baltimore, MD, USA.
3
Department of Medicine, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, Maharashtra, India.

Abstract

Delayed diagnosis of drug resistance has been a major obstacle to proper management and control of drug-resistant tuberculosis (TB). Expanded access to rapid molecular diagnostics such as Xpert MTB/RIF has been helpful, but has generated confusion about how to interpret genotype-phenotype discordance. Optimal management is not clearly defined for patients with rifampin resistance by Xpert MTB/RIF but rifampin susceptibility by phenotypic testing. To resolve this discrepancy, we performed pyrosequencing of discordant isolates identified at a reference laboratory over a 6-month period. We present here strategies to address genotype-phenotype discordance using sequencing.

KEYWORDS:

Culture; Xpert; discrepancy; pyrosequencing

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