Ajbani Kanchan, Kazi Mubin, Tornheim Jeffrey, Naik Swapna, Soman Rajeev, Shetty Anjali, Rodrigues Camilla
Department of Microbiology, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, Maharashtra, India.
Johns Hopkins University School of Medicine, Division of Infectious Diseases, Center for Clinical Global Health Education, Baltimore, MD, USA.
Lung India. 2018 Mar-Apr;35(2):168-170. doi: 10.4103/lungindia.lungindia_71_17.
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.
耐药性的延迟诊断一直是妥善管理和控制耐多药结核病的主要障碍。扩大对Xpert MTB/RIF等快速分子诊断方法的使用很有帮助，但在如何解释基因型与表型不一致方面引发了困惑。对于经Xpert MTB/RIF检测显示利福平耐药但经表型检测显示利福平敏感的患者，最佳管理方案尚无明确定义。为解决这一差异，我们对一家参考实验室在6个月期间鉴定出的不一致菌株进行了焦磷酸测序。我们在此介绍利用测序解决基因型与表型不一致的策略。
