High prevalence of multidrug-resistant tuberculosis among patients with rifampicin resistance using GeneXpert Mycobacterium tuberculosis/rifampicin in Ghana

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• 作者：Justice K. Boakye-Appiah^a ; ¹ ; Alexis R. Steinmetz^b ; ¹ ; ^{alexis.steinmetz@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Peter Pupulampu^c ; Stephen Ofori-Yirenkyi^d ; Ishmael Tetteh^a ; Michael Frimpong^e ; Patrick Oppong^a ; Ohene Opare-Sem^a ; ^f ; Betty R. Norman^a ; ^f ; Ymkje Stienstra^g ; Tjip S. van der Werf^g ; Mark Wansbrough-Jones^h ; Frank Bonsuⁱ ; Joseph Obeng-Baah^a ; Richard O. Phillips^a ; ^e
• 关键词：GeneXpert ; GeneXpert MTB/RIF ; Multidrug-resistant tuberculosis ; Xpert MTB/RIF
• 刊名：International Journal of Mycobacteriology
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：5
• 期：2
• 页码：226-230
• 全文大小：345 K

文摘

Drug-resistant strains of tuberculosis (TB) represent a major threat to global TB control. In low- and middle-income countries, resource constraints make it difficult to identify and monitor cases of resistance using drug susceptibility testing and culture. Molecular assays such as the GeneXpert Mycobacterium tuberculosis/rifampicin may prove to be a cost-effective solution to this problem in these settings. The objective of this study is to evaluate the use of GeneXpert in the diagnosis of pulmonary TB since it was introduced into two tertiary hospitals in Ghana in 2013.

Methods

A 2-year retrospective audit of clinical cases involving patients who presented with clinically suspected TB or documented TB not improving on standard therapy and had samples sent for GeneXpert testing.

Results

GeneXpert identified 169 cases of TB, including 17 cases of rifampicin-resistant TB. Of the seven cases with final culture and drug susceptibility testing results, six demonstrated further drug resistance and five of these were multidrug-resistant TB.

Conclusion

These findings call for a scale-up of TB control in Ghana and provide evidence that the expansion of GeneXpert may be an optimal means to improve case finding and guide treatment of drug-resistant TB in this setting.