Comparison of Nucleotide MALDI-TOF MS with Xpert MTB/RIF for Rifampicin Susceptibility Identification and Associated Risk Factors of Rifampicin Resistance Among Drug Resistant Mycobacterium tuberculosis.

IF 2.9 3区医学 Q2 INFECTIOUS DISEASES

Infection and Drug Resistance Pub Date : 2024-09-28 eCollection Date: 2024-01-01 DOI:10.2147/IDR.S473195

Song Song, Honghong Xu, Jiawei Cao, Guanghong Wu, Haiyan Sun, Xiaoqi Dai, Xuekui Li, Meng Chen, Menghan Zhang, Yueming Yan, Jingfeng Tong, Zhongdong Wang

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引用次数: 0

Abstract

Purpose: Nucleotide-based matrix-assisted laser desorption ionization time-of-flight mass spectrometry (nucleotide MALDI-TOF MS) is an emerging molecular technology used for the diagnosis of tuberculosis (TB) caused by Mycobacterium tuberculosis (MTB)and its drug resistance. This study aimed to compare the ability of nucleotide MALDI-TOF MS to detect rifampicin (RIF) resistance in drug-resistant TB (DR-TB) patients with Xpert MTB/RIF and to analyze the disparate results individually. Additionally, potential factors associated with rifampicin resistance among DR-TB patients in Qingdao were investigated.

Patients and methods: A retrospective study was conducted at Qingdao Chest Hospital, and patients with DR-TB were enrolled. Corresponding frozen isolates were recovered and subjected to nucleotide MALDI-TOF MS, Xpert MTB/RIF, and phenotypic drug susceptibility testing (pDST). Sanger sequencing was performed for the discordant results of nucleotide MALDI-TOF MS and Xpert MTB/RIF. Univariate and multivariate logistic regression analyses were used to identify potential factors associated with rifampicin resistance among patients with DR-TB.

Results: A total of 125 patients with DR-TB (18.8%, 125/668) were enrolled in this study from May 1 to July 31, 2023. Rifampicin-resistant (DR-TB/RR, 29) and rifampicin-sensitive (DR-TB/RS, 96) groups were divided according to the pDST results. Nucleotide MALDI-TOF MS performed better than Xpert MTB/RIF in terms of sensitivity, specificity, accuracy, and agreement with pDST. Only six cases had inconsistent results, and the sequencing results of five cases were identical to nucleotide MALDI-TOF MS. Furthermore, chest pain (aOR=12.84, 95% CI, 2.29-91.97, p=0.005), isoniazid sensitivity (aOR=0.14, 0.02-0.59, p=0.013), and ethambutol sensitivity (aOR=0.02, 0.00-0.10, p=0.000) were potential factors associated with rifampicin resistance among DR-TB patients in Qingdao.

Conclusion: The overall concordance between nucleotide MALDI-TOF MS and Xpert MTB/RIF was 95.2%, with the former performing better in determining rifampicin susceptibility among DR-TB cases in Qingdao. Chest pain, isoniazid, and ethambutol resistance might be factors associated with RIF resistance among patients with DR-TB in Qingdao.

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核苷酸 MALDI-TOF MS 与 Xpert MTB/RIF 在耐药结核分枝杆菌中鉴定利福平敏感性及相关利福平耐药风险因素的比较。

目的：基于核苷酸的基质辅助激光解吸电离飞行时间质谱（核苷酸 MALDI-TOF MS）是一种新兴的分子技术，用于诊断由结核分枝杆菌（MTB）引起的结核病（TB）及其耐药性。本研究旨在比较核苷酸 MALDI-TOF MS 与 Xpert MTB/RIF 检测耐药性肺结核（DR-TB）患者对利福平（RIF）耐药性的能力，并对不同的结果进行单独分析。此外，还调查了与青岛 DR-TB 患者耐利福平相关的潜在因素：青岛市胸科医院开展了一项回顾性研究，纳入了 DR-TB 患者。回收相应的冰冻分离株，并对其进行核苷酸 MALDI-TOF MS、Xpert MTB/RIF 和表型药敏试验（pDST）。对核苷酸 MALDI-TOF MS 和 Xpert MTB/RIF 的不一致结果进行了 Sanger 测序。采用单变量和多变量逻辑回归分析确定 DR-TB 患者对利福平耐药的潜在相关因素：从 2023 年 5 月 1 日到 7 月 31 日，共有 125 名 DR-TB 患者（18.8%，125/668）参与了这项研究。根据 pDST 结果分为利福平耐药组（DR-TB/RR，29 例）和利福平敏感组（DR-TB/RS，96 例）。核苷酸 MALDI-TOF MS 在灵敏度、特异性、准确性以及与 pDST 的一致性方面均优于 Xpert MTB/RIF。只有 6 个病例的结果不一致，5 个病例的测序结果与核苷酸 MALDI-TOF MS 相同。此外，胸痛（aOR=12.84，95% CI，2.29-91.97，p=0.005）、异烟肼敏感性（aOR=0.14，0.02-0.59，p=0.013）和乙胺丁醇敏感性（aOR=0.02，0.00-0.10，p=0.000）是青岛地区DR-TB患者对利福平耐药的潜在相关因素：结论：核苷酸MALDI-TOF MS与Xpert MTB/RIF的总体一致性为95.2%，前者在确定青岛地区DR-TB病例的利福平敏感性方面表现更好。胸痛、异烟肼和乙胺丁醇耐药可能是青岛地区DR-TB患者对利福平耐药的相关因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection and Drug Resistance Medicine-Pharmacology (medical)

CiteScore

5.60

自引率

7.70%

发文量

826

审稿时长

16 weeks

期刊介绍： About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.