1887
Rapid communication Open Access
Like 0

Abstract

This report documents the case of a Ukrainian patient infected with an extensively drug-resistant (XDR) lineage 2 strain harbouring the rifampicin resistance mutation RpoB I491F. This mutation is not detected by routine molecular WHO-recommended rapid diagnostics, complicating the detection and treatment of these strains. The occurrence of such mutations underscores the need for enhanced diagnostic techniques and tailored treatment regimens, especially in eastern Europe where lineage 2 strains and XDR-tuberculosis are prevalent.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2024.29.28.2400420
2024-07-11
2024-12-26
/content/10.2807/1560-7917.ES.2024.29.28.2400420
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/29/28/eurosurv-29-28-2_RYBNIKER.html?itemId=/content/10.2807/1560-7917.ES.2024.29.28.2400420&mimeType=html&fmt=ahah

References

  1. World Health Orgznization (WHO). Global tuberculosis report 2023. Geneva: WHO; 2023. Available from: https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2023
  2. World Health Organization (WHO). WHO operational handbook on tuberculosis: module 3: diagnosis: rapid diagnostics for tuberculosis detection: web annex B: critical concentrations for pretomanid and cycloserine: WHO policy statement. 3rd ed. Geneva: WHO; 2024. Available from: https://iris.who.int/handle/10665/376285
  3. Dooley KE, Hendricks B, Gupte N, Barnes G, Narunsky K, Whitelaw C, et al. Assessing pretomanid for tuberculosis (APT), a randomized phase 2 trial of pretomanid-containing regimens for drug-sensitive tuberculosis: 12-week results. Am J Respir Crit Care Med. 2023;207(7):929-35.  https://doi.org/10.1164/rccm.202208-1475OC  PMID: 36455068 
  4. Ignatius EH, Abdelwahab MT, Hendricks B, Gupte N, Narunsky K, Wiesner L, et al. Pretomanid pharmacokinetics in the presence of rifamycins: interim results from a randomized trial among patients with tuberculosis. Antimicrob Agents Chemother. 2021;65(2):e01196-20.  https://doi.org/10.1128/AAC.01196-20  PMID: 33229425 
  5. Modongo C, Barilar I, Wang Q, Molefi T, Makhondo T, Niemann S, et al. Tuberculosis variant with rifampin resistance undetectable by Xpert MTB/RIF, Botswana. Emerg Infect Dis. 2023;29(11):2403-6.  https://doi.org/10.3201/eid2911.230987  PMID: 37877680 
  6. Sanchez-Padilla E, Merker M, Beckert P, Jochims F, Dlamini T, Kahn P, et al. Detection of drug-resistant tuberculosis by Xpert MTB/RIF in Swaziland. N Engl J Med. 2015;372(12):1181-2.  https://doi.org/10.1056/NEJMc1413930  PMID: 25785984 
  7. Makhado NA, Matabane E, Faccin M, Pinçon C, Jouet A, Boutachkourt F, et al. Outbreak of multidrug-resistant tuberculosis in South Africa undetected by WHO-endorsed commercial tests: an observational study. Lancet Infect Dis. 2018;18(12):1350-9.  https://doi.org/10.1016/S1473-3099(18)30496-1  PMID: 30342828 
  8. Mon AS, Ei PW, Htwe MM, Nyunt MH, Win SM, Nyunt WW, et al. First detection of Mycobacterium tuberculosis clinical isolates harboring i491f borderline resistance rpob mutation in Myanmar. Antimicrob Agents Chemother. 2022;66(12):e0092522.  https://doi.org/10.1128/aac.00925-22  PMID: 36342155 
  9. Barilar I, Fernando T, Utpatel C, Abujate C, Madeira CM, José B, et al. Emergence of bedaquiline-resistant tuberculosis and of multidrug-resistant and extensively drug-resistant Mycobacterium tuberculosis strains with rpoB Ile491Phe mutation not detected by Xpert MTB/RIF in Mozambique: a retrospective observational study. Lancet Infect Dis. 2024;24(3):297-307.  https://doi.org/10.1016/S1473-3099(23)00498-X  PMID: 37956677 
  10. Beckert P, Sanchez-Padilla E, Merker M, Dreyer V, Kohl TA, Utpatel C, et al. MDR M. tuberculosis outbreak clone in Eswatini missed by Xpert has elevated bedaquiline resistance dated to the pre-treatment era. Genome Med. 2020;12(1):104.  https://doi.org/10.1186/s13073-020-00793-8  PMID: 33239092 
  11. Köser CU, Georghiou SB, Schön T, Salfinger M. On the consequences of poorly defined breakpoints for rifampin susceptibility testing of Mycobacterium tuberculosis complex. J Clin Microbiol. 2021;59(4):e02328-20.  https://doi.org/10.1128/JCM.02328-20  PMID: 33568463 
  12. Sonnenkalb L, Carter JJ, Spitaleri A, Iqbal Z, Hunt M, Malone KM, et al. Bedaquiline and clofazimine resistance in Mycobacterium tuberculosis: an in-vitro and in-silico data analysis. Lancet Microbe. 2023;4(5):e358-68.  https://doi.org/10.1016/S2666-5247(23)00002-2  PMID: 37003285 
  13. World Health Organization (WHO), European Centre for Disease Prevention and Control (ECDC). Tuberculosis surveillance and monitoring in Europe 2024 – 2022 data. Geneva: WHO, Stockholm: ECDC; 2024. Available from: https://www.ecdc.europa.eu/en/publications-data/tuberculosis-surveillance-and-monitoring-europe-2024-2022-data
/content/10.2807/1560-7917.ES.2024.29.28.2400420
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error