BACKGROUND: Recommended by the World Health Organization as an initial diagnostic test for TB in children, Xpert® MTB/RIF is widely implemented in many countries, including Kenya.
METHODS: Three hundred HIV-positive and negative children (
RESULTS: Of 32 children with bacteriologically confirmed TB, 27 had positive Xpert results. Of these, 3/27 (11%, 95% CI 4 28) had RIF resistance detected on Xpert, but not by phenotypic DST, line-probe assay, or sequencing. For these three children,
five Xpert tests showed RIF resistance; all five tests had semi-quantitative “very low” results and delay or absence of probe D signal, whereas no Xpert results with higher semi-quantitative results showed RIF resistance. All three children responded well to standard TB treatment.
False RIF resistance may be detected in pediatric specimens. Further study is needed to determine if false RIF resistance is associated with low bacterial load.
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Document Type: Research Article
Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya;
U.S. Centers for Disease Control and Prevention (CDC), Atlanta, GA USA
CDC, Kisumu, Kenya
Division of Infectious Diseases, Boston Children´s Hospital, Boston, MA, Department of Pediatrics, Harvard Medical School, Boston, MA, USA, Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK
01 November 2021
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