Journal of Clinical Tuberculosis and Other Mycobacterial Diseases最新文献

{"title":"Rifampicin-resistant Mycobacterium tuberculosis and unsuccessful results from Xpert® MTB/Rif-Ultra assay in Amhara Region, Ethiopia","authors":"Gizeaddis Belay ,&nbsp;Hailu Getachew ,&nbsp;Tigist Birku ,&nbsp;Aimro Tadese ,&nbsp;Yosef Gashaw ,&nbsp;Michael Getie ,&nbsp;Tazeb Molla ,&nbsp;Molalign Tarekegn ,&nbsp;Daniel Mekonnen ,&nbsp;Alemayehu Abate","doi":"10.1016/j.jctube.2025.100528","DOIUrl":"10.1016/j.jctube.2025.100528","url":null,"abstract":"<div><h3>Background</h3><div>Tuberculosis, an infectious disease caused by <em>Mycobacterium tuberculosis (Mtb),</em> causes 10 million new infections and 1.3 million deaths annually. The treatment of TB is hampered by the increasing incidence rate of<!--> <!-->drug resistance associated with<!--> <!-->TB. To diagnose TB and identify drug-resistant TB cases, rapid molecular technologies such as Xpert MTB/RIF, Truenat MTB, MTB Plus, and MTB-RIF Dx tests are recommended by the<!--> <!-->World Health Organization (WHO) and rolled out globally. Xpert MTB/RIF-Ultra assay is the most widely used in developing countries like Ethiopia. However, this rapid technology has inherent limitations, such as error reports, invalid results, and no results<!--> <!-->collectively reported as unsuccessful tuberculosis results. The purpose of this study was to retrospectively evaluate<!--> <!-->the trend of rifampicin resistance and unsuccessful results in the Xpert MTB/RIF-Ultra assay facility of Northwest Ethiopia.</div></div><div><h3>Methods</h3><div>Retrospective data archived in the<!--> <!-->Amhara Public Health Institute (APHI) TB laboratory from 2019 to 2024 were reviewed. Xpert MTB/RIF-Ultra software data were retrieved and transferred to Microsoft Excel. Then, it was checked for completeness, cleaned manually, and imported to Statistical Package for the Social Sciences (SPSS) version 25 software. The rate of <em>mycobacterium tuberculosis (Mtb.)</em> positives, multi-drug resistance tuberculosis (MDR-TB), and Unsuccessful results were analyzed from the total and year-wise. The final results were depicted using tables and different charts.</div></div><div><h3>Results</h3><div>From June 30, 2019, to June 30, 2024, a total of 587,128 sputum samples were obtained from presumptive TB patients in 111 GeneXpert sites in the<!--> <!-->Amhara Region. Of these samples analyzed using Xpert MTB/RIF-Ultra, 6.17 % (36,212/587,128) were Mtb positive. Furthermore, the overall proportion of rifampicin resistance (RR) among Mtb-confirmed cases decreased to 3.03 % (1,096/36,212) and showed a downward trend from 4.62 % (184/3979) in 2020 to 2 % (176/8806) in 2024. The overall unsuccessful results (error, invalid &amp; no result) were 6.48 %. The rate of unsuccessful results remained above the national target of &lt; 5 % throughout the study periods.</div></div><div><h3>Conclusion and recommendation</h3><div>The rate of <em>Mtb</em> and MDR-TB showed a decreasing trend in the last six years in Northwest Ethiopia. However, unsuccessful results remained above the national target. The cause of unsuccessful results should be investigated, and the Xpert MTB/RIF-Ultra-related quality assurance system must be enhanced to reduce the rate of Xpert MTB/RIF-Ultra unsuccessful results.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100528"},"PeriodicalIF":1.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of therapeutic threshold for tuberculosis using adapted nominal group technique and clinical vignettes in clinical and community settings in Southern Africa","authors":"Alfred Kipyegon Keter ,&nbsp;Alastair Van Heerden ,&nbsp;Tom Decroo ,&nbsp;Tom Boyles ,&nbsp;Shannon Bosman ,&nbsp;Thandanani Madonsela ,&nbsp;Lindani Innocent Msimango ,&nbsp;Lenika Naiken ,&nbsp;Carlos Kiyan ,&nbsp;Mashaete Kamele ,&nbsp;Irene Ayakaka ,&nbsp;Klaus Reither ,&nbsp;Bart Karl Mario Jacobs ,&nbsp;Lutgarde Lynen","doi":"10.1016/j.jctube.2025.100529","DOIUrl":"10.1016/j.jctube.2025.100529","url":null,"abstract":"<div><h3>Background</h3><div>When confronted with diagnostic uncertainty and a decision on whether to start treatment or not, clinicians consider the potential harm and benefit of offering versus withholding treatment. Treatment can be offered if the probability of tuberculosis (TB) in the patient is above the “therapeutic threshold” (ThT): the probability of disease at which the expected utility of treating and not treating is the same. We estimated ThT for TB in clinical and community settings in Southern Africa using two methods: an adapted nominal group technique (aNGT), and decisions made based on clinical vignettes (CVs).</div></div><div><h3>Methods</h3><div>We enrolled health professionals involved in the routine management of TB patients in South Africa and Lesotho. The participants elicited, discussed and refined the harms of false positive (FP) and false negative (FN) treatment decisions for stable ambulatory patients in the clinical and community settings. They weighed all harms according to their importance in treatment decisions by distributing 100 points. ThT, calculated as the sum of the weights of the harms of the FP decision divided by the total weight, was estimated using a hierarchical Beta regression model. For the CVs, participants were presented with ten hypothetical TB cases in each setting and asked to indicate whether they would offer TB treatment or not. ThT was estimated using the generalized linear model for binary outcomes.</div></div><div><h3>Results</h3><div>We enrolled 138 health professionals (aNGT: 123, CVs: 130 and 115 in both). Using aNGT, the overall ThT was 37.7% (95% credible intervals (95% CrI): 35.8–39.8) and 38.2% (95% CrI: 35.9–40.6) in the clinical and community settings, respectively. Compared to aNGT, CVs produced a significantly lower estimate in the clinical setting (27.7%; 95% CrI: 23.8–31.3) but similar in the community setting (37.7%; 95% CrI: 33.1–41.7). We did not find significant differences across the subgroups defined by the measured covariates.</div></div><div><h3>Conclusion</h3><div>The aNGT produced a reliable estimate of ThT. The difference in the estimates of ThT between the aNGT and CVs may have a limited impact on clinical decisions. Factors influencing ThT and the acceptability of results by healthcare workers will be explored in focus group discussions and in-depth interviews.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100529"},"PeriodicalIF":1.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cascade of care for the diagnosis and treatment of latent tuberculosis infection in an inner-city hospital prenatal clinic","authors":"Jay Phansalkar ,&nbsp;Rajas Karajgikar ,&nbsp;Jai Patel ,&nbsp;Shauna Williams ,&nbsp;Lisa Gittens-Williams ,&nbsp;Alfred A. Lardizabal","doi":"10.1016/j.jctube.2025.100527","DOIUrl":"10.1016/j.jctube.2025.100527","url":null,"abstract":"<div><div>Treating latent tuberculosis infection (LTBI) is a core intervention in reducing the burden of tuberculosis. Treatment for LTBI is challenging due to the many steps in the process, collectively termed the cascade of care. In pregnant patients with LTBI, these challenges are heightened due to the medical and social intricacies introduced by pregnancy. In this study, we evaluate the effectiveness of a screening intervention for LTBI in the prenatal clinic of an inner-city hospital in the United States, and analyze the cascade of care to identify areas for improvement. Of the n = 99 patients who had a positive QuantiFERON Gold Test (QFN), 96.7 % had a chest x-ray (CXR) ordered by their provider, 95.6 % completed the CXR, 82.8 % were referred to the TB clinic, 44.4 % scheduled an appointment with the TB clinic, 23.2 % attended an appointment at the TB clinic, 21.2 % started medical treatment of LTBI, and 17.2 % completed LTBI treatment. Together this data shows that majority of patients in the prenatal clinic with a positive QFN do not complete LTBI treatment. Most patients are lost during the steps that transition them from obstetric care to the care of the TB clinic. Improving the cascade of care for LTBI will require increased education of patients on the importance of treating LTBI, and improving the process that transitions patients from obstetric care to the care of the TB clinic.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100527"},"PeriodicalIF":1.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractory splenic tuberculosis in acute myeloid Leukemia: The role of advanced diagnostics and surgical intervention","authors":"Hongju Yan,&nbsp;Qin Wen,&nbsp;Xi Zhang","doi":"10.1016/j.jctube.2025.100525","DOIUrl":"10.1016/j.jctube.2025.100525","url":null,"abstract":"<div><div>AML patients are at a high risk of opportunistic infections, with tuberculosis (TB) being a common and challenging one. The immunosuppression caused by both AML and its treatment heightens this risk. Diagnosing TB in AML patients is difficult due to the overlapping symptoms of AML and TB. This case report presents a 22-year-old man diagnosed with AML who developed disseminated TB, manifesting as a refractory tuberculous splenic abscess. Despite achieving complete remission from initial induction chemotherapy, the patient experienced persistent fever. Next-generation sequencing revealed Mycobacterium tuberculosis infection, and anti-TB treatment was initiated. Despite regular anti-tuberculosis therapy, the patient continued to have recurrent fevers, with progressive splenic enlargement and an increase in splenic lesions. Eventually, splenectomy confirmed the presence of abscess-type splenic tuberculosis and resolved the symptoms. Despite the recurrence of leukemia in the bone marrow and the development of central nervous system leukemia during the patient’s treatment, complete remission was achieved again after re - induction chemotherapy and intrathecal chemotherapy. Then the patient underwent successful HSCT. This case highlights the diagnostic and therapeutic challenges in managing disseminated TB in AML patients. It underscores the importance of early and accurate diagnosis using advanced molecular techniques, close monitoring, and aggressive treatment. Surgical interventions should also be considered when standard treatments fail. Additionally, it emphasizes the need for proactive TB screening and prevention strategies in high-risk populations, such as AML patients undergoing chemotherapy.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100525"},"PeriodicalIF":1.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging gaps in tuberculosis control: addressing cross-border challenges between India and Pakistan","authors":"Harendra Kumar ,&nbsp;Fnu Teena ,&nbsp;Aneeta Bai ,&nbsp;Love Kumar ,&nbsp;Sebastian Gallego","doi":"10.1016/j.jctube.2025.100526","DOIUrl":"10.1016/j.jctube.2025.100526","url":null,"abstract":"<div><div>Tuberculosis (TB) continues to pose a substantial public health concern in South Asia, especially in India and Pakistan, which together represent a considerable portion of the worldwide TB burden. Notwithstanding national initiatives, international cooperation in tuberculosis control is insufficient, presenting a considerable obstacle to disease eradication. This viewpoint underscores the pressing need for improved collaboration between the two nations to tackle common difficulties, such as multidrug-resistant tuberculosis (MDR-TB), inadequate data exchange, and inconsistencies in treatment procedures. We suggest a framework to enhance bilateral tuberculosis control efforts via enhanced data-sharing methods, standardization of treatment regimens, collaborative research projects, and cross-border healthcare access. The formation of a regional tuberculosis task force and health corridors, equipped with diagnostic and treatment facilities, may improve disease monitoring and patient care, particularly in border areas. Moreover, combined training programs for healthcare professionals and legislative measures might enhance a more synchronized response. The World Health Organization (WHO) advocates for a worldwide plan to eradicate tuberculosis, presenting India and Pakistan with the potential to use international collaborations, like the Worldwide Fund and the Stop TB Partnership, to deploy novel diagnostic methods and therapies. A cohesive approach to tuberculosis enhances regional health security and establishes a benchmark for wider infectious disease management efforts. This viewpoint emphasizes the need for a collaborative strategy for tuberculosis control, promoting policy-oriented initiatives that surpass political divisions to attain a shared objective—diminishing tuberculosis incidence and enhancing public health outcomes in both countries.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100526"},"PeriodicalIF":1.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical presentations of mucocutaneous TB in HIV: A case series from South Africa","authors":"Mahlatse Cordelia Kgokolo ,&nbsp;Mohlominyane Jeffrey Mokheseng ,&nbsp;Jabulile Johanna Makhubele ,&nbsp;Shalate Charlotte Siwele ,&nbsp;Tinashe Irvin Maphosa ,&nbsp;Tsholofelo Kungoane","doi":"10.1016/j.jctube.2025.100524","DOIUrl":"10.1016/j.jctube.2025.100524","url":null,"abstract":"<div><h3>Introduction</h3><div>Tuberculosis (TB) remains a major burden of disease worldwide, especially in Human immunodeficiency virus (HIV)-infected patients. Cutaneous forms of TB account for approximately 10 % of all extrapulmonary tuberculosis cases, with oral manifestations accounting for less than 1 % of these cases. A high index of suspicion is essential when diagnosing rare clinical presentations. The response to treatment is excellent in most patients, particularly those receiving concomitant, effective antiretroviral (ARV) treatment.</div></div><div><h3>Patient presentation</h3><div>We report two cases of lupus vulgaris in AIDS patients (CD4 count of 113 cells/mm³ and 172 cells/mm³, respectively) and one case of mucosal TB in a patient with CD4 count of 365 cells/mm³. All the patients were adults referred to the dermatology clinic. The atypical clinical presentations included papules, plaques, and ulcers affecting unusual sites, such as the upper and lower limbs in the case of lupus vulgaris and a tongue ulcer in the patient with oral TB, emphasizing the importance of strong suspicion in HIV-infected patients. All available diagnostic measures were used to confirm the diagnosis.</div></div><div><h3>Management</h3><div>We demonstrate the importance of multidisciplinary care for patients and an excellent response to anti-TB treatment once diagnosed. We also emphasize the importance of concomitant ARV treatment and patient follow-up.</div></div><div><h3>Conclusion</h3><div>The outcomes of two of the three patients were good, highlighting the importance of timely clinical diagnosis and treatment, including monitoring and follow-up, while ensuring continued ARV treatment.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"40 ","pages":"Article 100524"},"PeriodicalIF":1.9,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of prior tuberculosis with altered cardiometabolic profiles of people with HIV: A comparative cross-sectional study in Uganda","authors":"Joseph Baruch Baluku ,&nbsp;Diana Karungi ,&nbsp;Brenda Namanda ,&nbsp;Sharon Namiiro ,&nbsp;Shamim Katusabe ,&nbsp;Angut Mary Madalen ,&nbsp;Martin Nabwana ,&nbsp;Ronald Olum ,&nbsp;Felix Bongomin ,&nbsp;Edwin Nuwagira ,&nbsp;Grace Kansiime ,&nbsp;Christian Kraef ,&nbsp;Megan Shaughnessy ,&nbsp;Joshua Rhein ,&nbsp;David Meya","doi":"10.1016/j.jctube.2025.100523","DOIUrl":"10.1016/j.jctube.2025.100523","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) is the leading cause of mortality among people with HIV (PWH), but the influence of co-infections like tuberculosis (TB) on CVD risk remains underexplored. We aimed to compare cardiometabolic profiles of PWH with and without prior TB to determine if prior TB is associated with distinct cardiometabolic profiles.</div></div><div><h3>Methods</h3><div>We conducted a comparative, cross-sectional study at a tertiary hospital in Kampala, Uganda. Participants were randomly sampled PWH aged ≥ 18 years on antiretroviral therapy. Specifically, we enrolled PWH with and without prior active TB (ratio of 1:1). Anthropometric measurements, blood pressure, fasting blood glucose (FBG), lipid profile, and glycated hemoglobin were assessed.</div></div><div><h3>Results</h3><div>A total of 396 participants were enrolled (196 TB survivors and 200 controls). TB survivors had higher median FBG (5.5 vs. 5.1 mmol/l, p &lt; 0.001) and a higher prevalence of DM (17.9 % vs. 9.5 %, p = 0.015). However, they had lower body mass index (23.0 vs. 25.1 kg/m², p &lt; 0.001) and waist circumference (81.0 vs. 84.0 cm, p = 0.026). TB survivors had higher HDL-c levels (1.0 vs. 0.8 mmol/l, p &lt; 0.001), lower LDL-c levels (2.7 vs. 3.1 mmol/l, p &lt; 0.001) and lower prevalence of dyslipidemia (81.7 % vs. 96.5 %, p &lt; 0.001). Prior TB was independently associated with higher prevalence of elevated FBG (adjusted prevalence ratio (aPR) 1.79, 95 % CI 1.10–2.92) and DM (aPR 2.34, 95 % CI 1.11–4.94), but decreased risk of obesity (aPR 0.42, 95 % CI 0.20–0.88).</div></div><div><h3>Conclusion</h3><div>TB survivors with HIV exhibit a higher risk of DM but lower risk of obesity compared to those without a history of TB, indicating a need for blood glucose monitoring among TB survivors.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100523"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matters of the heart: A scoping review toward better management of nontuberculous mycobacterial infections of cardiac devices","authors":"Rattanaporn Mahatanan ,&nbsp;Maria Alkozah ,&nbsp;Devin Lee ,&nbsp;Anais A. Ovalle ,&nbsp;Natalie B.V. Riblet ,&nbsp;Elizabeth A. Talbot","doi":"10.1016/j.jctube.2025.100521","DOIUrl":"10.1016/j.jctube.2025.100521","url":null,"abstract":"<div><h3>Background</h3><div>Implantable cardiac device-related (ICDR) nontuberculous mycobacteria (NTM) infections are increasingly reported in the literature, but guidelines for optimal management are lacking.</div></div><div><h3>Methods</h3><div>We searched Medline, Embase, and Scopus from inception to 1/20/2022 for cases of ICDR NTM infection. Cardiac devices include but are not limited to prosthetic valves, cardiovascular implantable device (CIED), and left ventricular-assist devices (LVAD). We categorized outcomes as death, failure, relapse, cure, and treatment complete.</div></div><div><h3>Main results</h3><div>A total of 81 articles met our inclusion criteria, representing 122 patients. Eleven different NTM species were reported, with rapidly growing mycobacteria (RGM) including <em>M. fortuitum, M. chelonae,</em> and <em>M. abscessus</em> comprising approximately 60 % of the identified organisms. Prosthetic heart valves (N = 61; 50 %) and CIED (N = 46; 38 %) were the most frequently associated cardiac devices. Favorable outcomes, defined as treatment complete and cure, were significantly associated with device removal after adjusting for age, gender, and device type (aOR 3.45, 95 %CI 1.30–9.14).</div></div><div><h3>Conclusion</h3><div>We found that patients who underwent device removal had better outcomes than those with retained devices. Device removal should be strongly considered when possible.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100521"},"PeriodicalIF":1.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengthening the global Response to Tuberculosis: Insights from the 2024 WHO global TB report","authors":"Fatemeh Estaji ,&nbsp;Ali Kamali ,&nbsp;Masoud Keikha","doi":"10.1016/j.jctube.2025.100522","DOIUrl":"10.1016/j.jctube.2025.100522","url":null,"abstract":"","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100522"},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of extensive drug resistance by the Xpert MTB/XDR assay in multidrug resistant tuberculosis cases at a tertiary care centre in northern India, and therapeutic decision making for the six-month BPaLM regimen","authors":"Richa Misra ,&nbsp;Parijat Das ,&nbsp;Alok Nath ,&nbsp;Zafar Neyaz","doi":"10.1016/j.jctube.2025.100520","DOIUrl":"10.1016/j.jctube.2025.100520","url":null,"abstract":"<div><div>The Xpert MTB/XDR assay has been approved by World Health Organization (WHO) as a reflex test on sputum samples after testing for rifampicin resistance. Recently, the Union Health Ministry of India in September 2024 approved the introduction of the six-month BPaLM regimen under its National TB Elimination Program (NTEP). In this study, the Xpert MTB/XDR assay was used to detect extensive drug resistance in pulmonary and extra-pulmonary tuberculosis patients with positive result for MTBC, and RIF resistance by the Xpert MTB/RIF ULTRA assay. We also aimed to assess the eligibility of patients for the BPaLM regimen based on the drug susceptibility profile of this test in a high burden Indian setting.</div><div>We conducted a single centre prospective cohort study between January 2023 to August 2024 on 42 old, and 68 new patients presenting with MDR/RR tuberculosis. A total of 110 samples (82 pulmonary and 28 extra pulmonary samples) were included in the study. The Xpert MTB/XDR assay was used to determine the susceptibilities to isoniazid, fluoroquinolones, amikacin, kanamycin, capreomycin, and ethionamide.</div><div>Out of 110 samples processed, 13 samples were ‘not detected’ by the assay while three gave invalid results. Resistance to isoniazid, fluoroquinolones, amikacin, kanamycin, capreomycin and ethionamide was detected in 85/94 cases (90·42%), 74/94 cases (78·72%), 08/94 cases (8·5%), 13/94 cases (13·83%), 08/94 cases (8·5%), and 14/94 cases (14·89%) respectively.</div><div>With the updated definitions of drug-resistant TB and high burden of fluoroquinolone resistance the Xpert MTB/XDR assay has a limited application in India.</div><div>Detection of extensive drug resistance by the Xpert MTB/XDR assay in multidrug resistant tuberculosis cases at a tertiary care centre in northern India, and therapeutic decision making for the six-month BPaLM regimen.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"39 ","pages":"Article 100520"},"PeriodicalIF":1.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143685872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}