Missed rifampicin and isoniazid resistance by commercial molecular assays

Authors

  • L Richards Division of Infectious Diseases, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa https://orcid.org/0000-0003-1723-0382
  • F Ismail Centre for Tuberculosis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa; Department of Medical Microbiology, School of Medicine, University of Pretoria, South Africa https://orcid.org/0000-0003-3070-9806
  • J Nel Division of Infectious Diseases, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  • S V Omar Centre for Tuberculosis, National Institute for Communicable Diseases, Division of the National Health Laboratory Services, Johannesburg, South Africa, Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa and Department of Molecular Medicine, University of Witwatersrand, Johannesburg, South Africa; Department of Molecular Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa https://orcid.org/0000-0001-6983-1636

DOI:

https://doi.org/10.7196/SAMJ.2024.v114i17.1779

Keywords:

Multidrug resistant TB, TB diagnostics

Abstract

Drug-resistant tuberculosis (TB) has poor outcomes unless resistance is detected early, ideally by commercially available molecular tests. We present a case of occult multidrug-resistant TB where both rifampicin and isoniazid resistance were missed by molecular testing and were only identified by phenotypic testing.

Author Biographies

  • L Richards, Division of Infectious Diseases, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

    Consultant at Helen Joseph Hospital in the division of infectious diseases, department of internal medicine.

  • F Ismail, Centre for Tuberculosis, National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa; Department of Medical Microbiology, School of Medicine, University of Pretoria, South Africa

    Farzana Ismail is the pathologist at the Centre for Tuberculosis at the National Institute for Communicable Diseases, and leads the WHO Supranational TB Reference laboratory section of the centre, while providing support to other National TB reference laboratories in the region. 

  • J Nel, Division of Infectious Diseases, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

    Consultant at Helen Joseph Hospital in the division of infectious diseases, department of internal medicine.

  • S V Omar, Centre for Tuberculosis, National Institute for Communicable Diseases, Division of the National Health Laboratory Services, Johannesburg, South Africa, Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa and Department of Molecular Medicine, University of Witwatersrand, Johannesburg, South Africa; Department of Molecular Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

    Shaheed Vally Omar is a medical Scientist with specialisation in Microbiology, focusing on Mycobacterium tuberculosis research since his post-graduate training. He currently leads the following scientific programmes in the Centre for Tuberculosis at the National Institute for Communicable Diseases in Johannesburg, South Africa; diagnostic evaluations for both active and latent disease state; drug resistance determination and surveillance; molecular epidemiology of drug resistance tuberculosis; and the application of novel technologies for these purposes. He further is the lead scientist of the National TB Reference Laboratory as well as the WHO TB Supranational Laboratory Network.

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Published

2024-07-01

Issue

Section

In Practice

How to Cite

1.
Richards L, Ismail F, Nel J, Omar SV. Missed rifampicin and isoniazid resistance by commercial molecular assays. S Afr Med J [Internet]. 2024 Jul. 1 [cited 2024 Jul. 18];114(7):e1779. Available from: https://samajournals.co.za/index.php/samj/article/view/1779

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