ArticleJournal of clinical microbiology2013
Rifampin resistance missed in automated liquid culture system for Mycobacterium tuberculosis isolates with specific rpoB mutations.
Article in Journal of clinical microbiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 120 papers, 3 of them syntheses that pooled it.
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Who cites it
120 citing papers in PubMed, 3 syntheses or guidelines pooled it, 205 citations in OpenAlex.
- Systematic Review of Whole-Genome Sequencing Data To Predict Phenotypic Drug Resistance and Susceptibility in Swedish Mycobacterium tuberculosis Isolates, 2016 to 2018.Antimicrobial agents and chemotherapy · 2020Pooled it
- Non-commercial phenotypic assays for the detection of Mycobacterium tuberculosis drug resistance: a systematic review.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Pooled it
- Evaluation of parameters affecting performance and reliability of machine learning-based antibiotic susceptibility testing from whole genome sequencing data.PLoS computational biology · 2019Pooled it
- Longitudinal Analysis of Prevalence and Risk Factors of Rifampicin-Resistant Tuberculosis in Zhejiang, China.BioMed research international · 2020Trial
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- Genomic insights into low-level rifampicin resistance mediated by borderlineMicrobiology spectrum · 2026Article
- Phenotypic discordance in rifampicin resistance detection amongMicrobiology spectrum · 2026Review
- Assessing fluoroquinolone resistance in Mycobacterium tuberculosis using nanopore sequencing: concordance with established diagnostic methods.Infection · 2026Article
- Accuracy of the Phenotypic 1G Test to Detect Mycobacterium tuberculosis and Drug Resistance From Sputa in the US-Mexico Border.The Journal of infectious diseases · 2026Article
- Implementation of sequencing-based surveillance for drug-resistant tuberculosis in Nigeria.Frontiers in tuberculosis · 2026Article
- Beyond Hotspot Mutations: Diagnostic Relevance of High Frequency, Low Frequency, and DisputedPathogens (Basel, Switzerland) · 2025Review
- A novel one-tube nested fluorescence melting curve analysis for rapid detection of drug-resistant Mycobacterium tuberculosis.BMC microbiology · 2025Article
- Single-Sample Melt-Based Screening for Rifampicin Susceptibility in the Emerging Mutation Hotspot atACS infectious diseases · 2025Article
- Diagnostic accuracy of direct drug susceptibility testing of second-line antitubercular drugs.Microbiology spectrum · 2025Article
- Discordance in genotypic and phenotypic drug susceptibility results: time to reconsider critical concentration of rifampicin.Microbiology spectrum · 2025Article
- Implementation of Whole Genome Sequencing of Tuberculosis Isolates in a Referral Center in Rome: Six Years' Experience in Characterizing Drug-Resistant TB and Disease Transmission.Antibiotics (Basel, Switzerland) · 2024Article
- Phenotype versus genotype discordant rifampicin susceptibility testing in tuberculosis: implications for a diagnostic accuracy.Microbiology spectrum · 2024Article
- Effects of sputum bacillary load and age on GeneXpert and traditional methods in pulmonary tuberculosis: a 4-year retrospective comparative study.BMC infectious diseases · 2023Article
- Whole genome sequencing of drug resistanceLife science alliance · 2023Article
60 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
WHO-endorsed phenotypic drug susceptibility testing (DST) methods for Mycobacterium tuberculosis are assumed to be the gold standard for identifying rifampin (RMP) resistance. However, previous results indicated that low-level, yet probably clinically relevant, RMP resistance linked to specific rpoB mutations is easily missed by some growth-based methods. We aimed to compare the level of resistance detected on Löwenstein-Jensen (LJ) medium with resistance detected by the Bactec MGIT 960 automated DST (MGIT-DST) system for various rpoB mutants. Full agreement between LJ and MGIT-DST was observed for mutations located at codons 513 (Lys or Pro) and 531 (Leu, Trp), which were always resistant by both methods. For mutations 511Pro, 516Tyr, 533Pro, 572Phe, and several 526 mutations, LJ and MGIT results were highly discordant, with MGIT-DST failing to give a result or declaring the strains susceptible. Our data show that phenotypic RMP resistance testing of M. tuberculosis is not a binary phenomenon for some rpoB mutations and that the widely used automated MGIT 960 system is prone to miss some RMP resistance-conferring mutations, while careful DST on LJ missed hardly any. Given the association of these mutations with poor clinical outcome, our findings suggest that the gold standard for rifampin resistance should be reconsidered, in order to address the present confusion caused by discrepancies between phenotypic and genotypic results. The impacts of these mutations will depend on the frequency of their occurrence, which may vary from one setting to another.
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