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A pseudo-outbreak of pre-XDR TB in Kinshasa: a collateral damage of false fluoroquinolone resistant detection by GenoType(R) MTBDRsl

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dc.contributor.author Kaswa, M. K. en_US
dc.contributor.author Aloni, M. en_US
dc.contributor.author Nkuku, L. en_US
dc.contributor.author Bakoko, B. en_US
dc.contributor.author Lebeke, R. en_US
dc.contributor.author Nzita, A. en_US
dc.contributor.author Muyembe, J. J. en_US
dc.contributor.author de Jong, B. C. en_US
dc.contributor.author De Rijk, P. en_US
dc.contributor.author Verhaegen, J. en_US
dc.contributor.author Boelaert, M. en_US
dc.contributor.author Ieven, M. en_US
dc.contributor.author Van Deun, A. en_US
dc.date.accessioned 2014-09-25T13:39:50Z
dc.date.available 2014-09-25T13:39:50Z
dc.date.issued 2014 en_US
dc.identifier.issn 0095-1137 en_US
dc.identifier.doi http://dx.doi.org/10.1128/JCM.00398-14 en_US
dc.identifier.other ITG-B1B; ITG-B8A; ITG-B9A; ITG-H11A; ITG-BLA; MULTI; DBM; U-MYCOB; DPH; U-ECTD; ZRB; JIF; DOI; Abstract; UPD56 en_US
dc.identifier.uri http://hdl.handle.net/10390/7911
dc.description.abstract Fluoroquinolones are the core drugs for management of multidrug-resistant tuberculosis (MDR-TB). Molecular drug susceptibility testing methods have considerable advantages for scaling up programmatic management and surveillance of drug-resistant TB. We describe misidentification of fluoroquinolone resistance by the GenoType(R)MTBDRsl (MTBDRsl, Hain Lifescience GmbH, Nehren, Germany) Line Probe Assay (LPA) encountered during a feasibility and validation study for the introduction of this rapid drug susceptibility test in Kinshasa, Democratic Republic of Congo. The double gyrA mutation 80Ala and 90Gly represented 57% of all fluoroquinolone mutations identified from MDR-TB patient sputum samples, as confirmed by DNA sequencing. This double mutation was previously found to be associated with susceptibility to fluoroquinolones, yet leads to absent hybridization of a wildtype band in the MTBDRsl and is thus falsely scored as resistance. Our findings suggest to interpret MTBDRsl results with caution when the interpretation is solely based on the absence of a wildtype band without confirmation by visualization of a mutant band. Performance of the MTBDRsl LPA could be improved replacing the gyrA wildtype probes by additional probes specific for well documented gyrA mutations that confer clinically relevant resistance. en_US
dc.language English en_US
dc.subject Bacterial diseases en_US
dc.subject Tuberculosis en_US
dc.subject Mycobacterium tuberculosis en_US
dc.subject Multidrug resistance en_US
dc.subject Outbreaks en_US
dc.subject False-positive en_US
dc.subject Detection en_US
dc.subject Fluoroquinolones en_US
dc.subject Susceptibility en_US
dc.subject Molecular diagnostic techniques en_US
dc.subject Mutations en_US
dc.subject Hybridization en_US
dc.subject Performance en_US
dc.subject Rapid diagnostic tests en_US
dc.subject Congo-Kinshasa en_US
dc.subject Africa, Central en_US
dc.title A pseudo-outbreak of pre-XDR TB in Kinshasa: a collateral damage of false fluoroquinolone resistant detection by GenoType(R) MTBDRsl en_US
dc.type Article en_US
dc.citation.issue 8 en_US
dc.citation.jtitle Journal of Clinical Microbiology en_US
dc.citation.volume 52 en_US
dc.citation.pages 2876-2880 en_US
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/24871222 en_US
dc.citation.jabbreviation J Clin Microbiol en_US


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