Evidence map›Paper›PMID 39175078›Full record

ArticleAnnals of clinical microbiology and antimicrobials2024

Clinical application of whole-genome sequencing in the management of extensively drug-resistant tuberculosis: a case report.

Bugwesa Z Katale, Sylvia Rofael, Linzy Elton, Erasto V Mbugi, Stella G Mpagama, Daphne Mtunga, Maryjesca G Mafie, Peter M Mbelele, Charlotte Williams, Happiness C Mvungi and 5 more

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of clinical microbiology and antimicrobials, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Bugwesa Z KataleTanzania Commission for Science and Technology (COSTECH), P.O. BOX 4302, Dar es Salaam, Tanzania. bugwesa2002@yahoo.co.uk.
Sylvia RofaelCentre for Clinical Microbiology, University College London (UCL), Royal Free Campus, Rowland Hill Street, London, NW3 2QG, UK.
Linzy EltonCentre for Clinical Microbiology, University College London (UCL), Royal Free Campus, Rowland Hill Street, London, NW3 2QG, UK.
Erasto V MbugiDepartment of Biochemistry and Molecular Biology, Muhimbili University of Health and Allied Sciences (MUHAS), P.O. BOX 65001, Dar es Salaam, Tanzania.
Stella G MpagamaKibong'oto Infectious Diseases Hospital (KIDH), P.O. BOX 12, Mae Street, Siha, Kilimanjaro, Tanzania.
Daphne MtungaCentral Tuberculosis Reference Laboratory, National Tuberculosis and Leprosy Programme, Muhimbili National Hospital, P.O Box 65000, Dar es Salaam, Tanzania.
Maryjesca G MafieCentral Tuberculosis Reference Laboratory, National Tuberculosis and Leprosy Programme, Muhimbili National Hospital, P.O Box 65000, Dar es Salaam, Tanzania.
Peter M MbeleleKibong'oto Infectious Diseases Hospital (KIDH), P.O. BOX 12, Mae Street, Siha, Kilimanjaro, Tanzania.
Charlotte WilliamsCentre for Clinical Microbiology, University College London (UCL), Royal Free Campus, Rowland Hill Street, London, NW3 2QG, UK.
Happiness C MvungiKibong'oto Infectious Diseases Hospital (KIDH), P.O. BOX 12, Mae Street, Siha, Kilimanjaro, Tanzania.
Rachel WilliamsCentre for Clinical Microbiology, University College London (UCL), Royal Free Campus, Rowland Hill Street, London, NW3 2QG, UK.
Gulinja A SakuKibong'oto Infectious Diseases Hospital (KIDH), P.O. BOX 12, Mae Street, Siha, Kilimanjaro, Tanzania.
Joanitha A RutaKibong'oto Infectious Diseases Hospital (KIDH), P.O. BOX 12, Mae Street, Siha, Kilimanjaro, Tanzania.
Timothy D McHughCentre for Clinical Microbiology, University College London (UCL), Royal Free Campus, Rowland Hill Street, London, NW3 2QG, UK.
Mecky I MateeDepartment of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences (MUHAS), P.O. BOX 65001, Dar es Salaam, Tanzania.

Funding

European & Developing Countries Clinical Trials Partnership (EDCTP) TMA2018CDF-2363
6 · The paper itself

Abstract

backgroundWhole-genome sequencing (WGS)-based prediction of drug resistance in Mycobacterium tuberculosis has the potential to guide clinical decisions in the design of optimal treatment regimens.

methodsWe utilized WGS to investigate drug resistance mutations in a 32-year-old Tanzanian male admitted to Kibong'oto Infectious Diseases Hospital with a history of interrupted multidrug-resistant tuberculosis treatment for more than three years. Before admission, he received various all-oral bedaquiline-based multidrug-resistant tuberculosis treatment regimens with unfavourable outcomes.

resultsDrug susceptibility testing of serial M. tuberculosis isolates using Mycobacterium Growth Incubator Tubes culture and WGS revealed resistance to first-line anti-TB drugs, bedaquiline, and fluoroquinolones but susceptibility to linezolid, clofazimine, and delamanid. WGS of serial cultured isolates revealed that the Beijing (Lineage 2.2.2) strain was resistant to bedaquiline, with mutations in the mmpR5 gene (Rv0678. This study also revealed the emergence of two distinct subpopulations of bedaquiline-resistant tuberculosis strains with Asp47f and Glu49fs frameshift mutations in the mmpR5 gene, which might be the underlying cause of prolonged resistance. An individualized regimen comprising bedaquiline, delamanid, pyrazinamide, ethionamide, and para-aminosalicylic acid was designed. The patient was discharged home at month 8 and is currently in the ninth month of treatment. He reported no cough, chest pain, fever, or chest tightness but still experienced numbness in his lower limbs.

conclusionWe propose the incorporation of WGS in the diagnostic framework for the optimal management of patients with drug-resistant and extensively drug-resistant tuberculosis.

Indexed as

Antitubercular AgentsExtensively Drug-Resistant TuberculosisMicrobial Sensitivity TestsMycobacterium tuberculosisWhole Genome SequencingAdultDiarylquinolinesDrug Resistance, Multiple, BacterialGenome, BacterialHumansLinezolidMaleMutationTanzaniaAntitubercular AgentsbedaquilineDiarylquinolinesLinezolidCase ReportClinical applicationGenomic DiagnosticsWhole-genome sequencingXDR-TB

Identifiers

PMID39175078
PMCPMC11342570

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.