Fluorescein diacetate and rapid molecular testing for the early identification of rifampicin resistance in Mali
| Autor: | Mamoudou Maiga, Ibrahim Maiga, Bocar Baya, Yeya dit Sadio Sarro, Fatimata Diallo, B. Konate, Mohamed Tolofoudie, Bassirou Diarra, B. C. de Jong, Sounkalo Dao, A. C. G. Togo, Boureima Degoga, Ousmane Kodio, Leen Rigouts, Sophia Siddiqui, M. Diakite, Gagni Coulibaly, Seydou Doumbia, A. B. Cisse, A. Van Deun, Amadou Kone, Y. Toloba, Amadou Somboro, Robert L. Murphy, Mahamadou Kone, Tom Decroo, Moumine Sanogo, Souleymane Diallo |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Fluorescein diacetate Tuberculosis Drug resistance Mali Stain Sensitivity and Specificity Drug Resistance Bacterial Tuberculosis Multidrug-Resistant medicine Humans biology business.industry Sputum Mycobacterium tuberculosis rpoB medicine.disease biology.organism_classification Fluoresceins Virology Multiple drug resistance Infectious Diseases Molecular Diagnostic Techniques Human medicine medicine.symptom Rifampin business Bacteria |
| Zdroj: | International journal of tuberculosis and lung disease |
| ISSN: | 1815-7920 1027-3719 |
| Popis: | BACKGROUND: Non-conversion on auramine smear microscopy indicates a lack of treatment response, possibly associated with initial rifampicin-resistant tuberculosis (RR-TB). However, dead bacteria still stain positive and may be detected. Fluorescein diacetate smear microscopy (FDA) shows live mycobacteria only. Therefore, we studied the potential of 2-month (2M) FDA for the identification of initial RR-TB.METHODS: Between 2015 and 2018, we enrolled new smear-positive pulmonary TB patients from five local centres in Bamako, Mali. After baseline screening, sputum samples were collected at 1M, 2M, 5M and 18M. We used rpoB sequencing to identify initial RR-TB.RESULTS: Of 1359 patients enrolled, 1019 (75%) had rpoB sequencing results. Twenty-six (2.6%, 95%CI: 1.7–3.7) had mutations conferring rifampicin resistance. Most frequent rpoB mutations were located at the codons Asp435Val (42.4%) and Ser450Leu (34.7%). Among patients with initial RR-TB, 72.2% were FDA-negative at 2M (P = 0.2). The positive and negative predictive value of 5M FDA for culture-based failure was respectively 20.0% and 94.7%.CONCLUSION: FDA did not identify the majority of patients with initial RR-TB or culture-based failure. As the full spectrum of mutations identified on sequencing was identified using Xpert, our data support its rapid universal implementation in Mali. |
| Databáze: | OpenAIRE |
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