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dc.contributor.authorMbelele, Peter
dc.contributor.authorSauli, Elingarami
dc.contributor.authorMpolya, Emmanuel
dc.contributor.authorMohamed, Sagal
dc.contributor.authorAddo, Kennedy
dc.contributor.authorMfinanga, Sayoki
dc.contributor.authorHeysell, Scott
dc.contributor.authorMpagama, Stellah
dc.date.accessioned2023-10-17T07:48:05Z
dc.date.available2023-10-17T07:48:05Z
dc.date.issued2021-06-09
dc.identifier.urihttps://doi.org/10.1111/tmi.13638
dc.identifier.urihttps://dspace.nm-aist.ac.tz/handle/20.500.12479/2318
dc.descriptionA research article was submitted by Tropical Medicine and International Health Volume26, Issue9 September 2021en_US
dc.description.abstractObjectives Differences among Mycobacterium tuberculosis complex (MTC) species may predict drug resistance or treatment success. Thus, we optimised and deployed the genotype MTBC assay (gMTBC) to identify MTC to the species level, and then performed comparative genotypic drug-susceptibility testing to anti-tuberculosis drugs from direct sputum of patients with presumed multidrug-resistant tuberculosis (MDR-TB) by the MTBDRplus/sl reference method. Methods Patients with positive Xpert® MTB/RIF (Xpert) results were consented to provide early-morning-sputum for testing by the gMTBC and the reference MTBDRplus/sl. Chi-square or Fisher’s exact test compared proportions. Modified Poisson regression modelled detection of MTC by gMTBC. Results Among 73 patients, 53 (73%) were male and had a mean age of 43 (95% CI; 40–45) years. In total, 34 (47%), 36 (49%) and 38 (55%) had positive gMTBC, culture and MTBDR respectively. Forty patients (55%) had low quantity MTC by Xpert, including 31 (78%) with a negative culture. gMTBC was more likely to be positive in patients with chest cavity 4.18 (1.31–13.32, P = 0.016), high-quantity MTC by Xpert 3.03 (1.35–6.82, P = 0.007) and sputum smear positivity 1.93 (1.19–3.14, P = 0.008). The accuracy of gMTBC in detecting MTC was 95% (95% CI; 86–98; κ = 0.89) compared to MTBDRplus/sl. All M. tuberculosis/canettii identified by gMTB were susceptible to fluoroquinolone and aminoglycosides/capreomycin. Conclusions The concordance between the gMTBC assay and MTBDRplus/sl in detecting MTC was high but lagged behind the yield of Xpert MTB/RIF. All M. tuberculosis/canettii were susceptible to fluoroquinolones, a core drug in MDR-TB treatment regimens.en_US
dc.language.isoenen_US
dc.publisherTropical Medicine and International Healthen_US
dc.subjectgenotype MTBCen_US
dc.subjecttuberculosis complex speciesen_US
dc.subjectmultidrug-resistanten_US
dc.subjectsputumen_US
dc.titleTB or not TB? Definitive determination of species within the Mycobacterium tuberculosis complex in unprocessed sputum from adults with presumed multidrug-resistant tuberculosisen_US
dc.typeArticleen_US


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