Fluorescein diacetate and rapid molecular testing for the early identification of rifampicin resistance in Mali

Bassirou Diarra; T. Decroo; A. Somboro; G. Coulibaly; M. Tolofoudie; M. Kone; B. Degoga; F. Diallo; A. C.G. Togo; M. Sanogo; Y. S. Sarro; A. B. Cisse; O. Kodio; B. Baya; A. Kone; M. Maiga; S. Dao; I. I. Maiga; R. L. Murphy; S. Siddiqui; Y. Toloba; B. Konate; M. Diakite; S. Doumbia; A. Van Deun; L. Rigouts; S. Diallo; B. C. De Jong

doi:10.5588/ijtld.19.0698

Fluorescein diacetate and rapid molecular testing for the early identification of rifampicin resistance in Mali

Bassirou Diarra^*, T. Decroo, A. Somboro, G. Coulibaly, M. Tolofoudie, M. Kone, B. Degoga, F. Diallo, A. C.G. Togo, M. Sanogo, Y. S. Sarro, A. B. Cisse, O. Kodio, B. Baya, A. Kone, M. Maiga, S. Dao, I. I. Maiga, R. L. Murphy, S. SiddiquiY. Toloba, B. Konate, M. Diakite, S. Doumbia, A. Van Deun, L. Rigouts, S. Diallo, B. C. De Jong

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

Abstract

BACKGROUND: Non-conversion on auramine smear microscopy indicates a lack of treatment response, possibly associated with initial rifampicin-resistant tuberculosis (RR-TB). However, dead bacteria still stain positive and may be detected. Fluorescein diacetate smear microscopy (FDA) shows live mycobacteria only. Therefore, we studied the potential of 2-month (2M) FDA for the identification of initial RRTB. METHODS: Between 2015 and 2018, we enrolled new smear-positive pulmonary TB patients from five local centres in Bamako, Mali. After baseline screening, sputum samples were collected at 1M, 2M, 5M and 18M. We used rpoB sequencing to identify initial RRTB. RESULTS: Of 1359 patients enrolled, 1019 (75%) had rpoB sequencing results. Twenty-six (2.6%, 95%CI: 1.7a-3.7) had mutations conferring rifampicin resistance. Most frequent rpoB mutations were located at the codons Asp435Val (42.4%) and Ser450Leu (34.7%). Among patients with initial RR-TB, 72.2% were FDAnegative at 2M (P Â 0.2). The positive and negative predictive value of 5M FDA for culture-based failure was respectively 20.0% and 94.7%. CONCLUSION: FDA did not identify the majority of patients with initial RR-TB or culture-based failure. As the full spectrum of mutations identified on sequencing was identified using Xpert, our data support its rapid universal implementation in Mali.

Original language	English (US)
Pages (from-to)	763-769
Number of pages	7
Journal	International Journal of Tuberculosis and Lung Disease
Volume	24
Issue number	8
DOIs	https://doi.org/10.5588/ijtld.19.0698
State	Published - Aug 1 2020

Keywords

FDA
Mali
rpoB
sequencing

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.5588/ijtld.19.0698

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Diarra, B., Decroo, T., Somboro, A., Coulibaly, G., Tolofoudie, M., Kone, M., Degoga, B., Diallo, F., Togo, A. C. G., Sanogo, M., Sarro, Y. S., Cisse, A. B., Kodio, O., Baya, B., Kone, A., Maiga, M., Dao, S., Maiga, I. I., Murphy, R. L., ... De Jong, B. C. (2020). Fluorescein diacetate and rapid molecular testing for the early identification of rifampicin resistance in Mali. International Journal of Tuberculosis and Lung Disease, 24(8), 763-769. https://doi.org/10.5588/ijtld.19.0698

@article{d1e6ceb5bf2d4a86b22d795534ee0c66,

title = "Fluorescein diacetate and rapid molecular testing for the early identification of rifampicin resistance in Mali",

abstract = "BACKGROUND: Non-conversion on auramine smear microscopy indicates a lack of treatment response, possibly associated with initial rifampicin-resistant tuberculosis (RR-TB). However, dead bacteria still stain positive and may be detected. Fluorescein diacetate smear microscopy (FDA) shows live mycobacteria only. Therefore, we studied the potential of 2-month (2M) FDA for the identification of initial RRTB. METHODS: Between 2015 and 2018, we enrolled new smear-positive pulmonary TB patients from five local centres in Bamako, Mali. After baseline screening, sputum samples were collected at 1M, 2M, 5M and 18M. We used rpoB sequencing to identify initial RRTB. RESULTS: Of 1359 patients enrolled, 1019 (75%) had rpoB sequencing results. Twenty-six (2.6%, 95%CI: 1.7a-3.7) had mutations conferring rifampicin resistance. Most frequent rpoB mutations were located at the codons Asp435Val (42.4%) and Ser450Leu (34.7%). Among patients with initial RR-TB, 72.2% were FDAnegative at 2M (P {\^A} 0.2). The positive and negative predictive value of 5M FDA for culture-based failure was respectively 20.0% and 94.7%. CONCLUSION: FDA did not identify the majority of patients with initial RR-TB or culture-based failure. As the full spectrum of mutations identified on sequencing was identified using Xpert, our data support its rapid universal implementation in Mali.",

keywords = "FDA, Mali, rpoB, sequencing",

author = "Bassirou Diarra and T. Decroo and A. Somboro and G. Coulibaly and M. Tolofoudie and M. Kone and B. Degoga and F. Diallo and Togo, {A. C.G.} and M. Sanogo and Sarro, {Y. S.} and Cisse, {A. B.} and O. Kodio and B. Baya and A. Kone and M. Maiga and S. Dao and Maiga, {I. I.} and Murphy, {R. L.} and S. Siddiqui and Y. Toloba and B. Konate and M. Diakite and S. Doumbia and {Van Deun}, A. and L. Rigouts and S. Diallo and {De Jong}, {B. C.}",

note = "Funding Information: This work was done at the University Clinical Research Center of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Mali, and was partially funded by the USTTB through NIH/R01 grant R01AI110386 and NIH/FIC D71 TWO10428-01A1, the Northwestern University (Chicago, IL, USA) through NIH/FIC D43 TW10350. The content of this publication does not necessarily reflect the views or policies of the US Department of Health and Human Services, nor does mention of trade names, commercial products, or organisations imply endorsement by the US Government. Funding Information: BD was supported by a TDR fellowship, TIMS ID B40072, the special programme for research and training in tropical diseases, co-sponsored by UNICEF, UNDP, World Bank and the WHO. Conflicts of interest: none declared. Publisher Copyright: {\textcopyright} 2020 International Union against Tubercul. and Lung Dis.. All rights reserved.",

year = "2020",

month = aug,

day = "1",

doi = "10.5588/ijtld.19.0698",

language = "English (US)",

volume = "24",

pages = "763--769",

journal = "International Journal of Tuberculosis and Lung Disease",

issn = "1027-3719",

publisher = "International Union against Tubercul. and Lung Dis.",

number = "8",

}

Diarra, B, Decroo, T, Somboro, A, Coulibaly, G, Tolofoudie, M, Kone, M, Degoga, B, Diallo, F, Togo, ACG, Sanogo, M, Sarro, YS, Cisse, AB, Kodio, O, Baya, B, Kone, A, Maiga, M, Dao, S, Maiga, II, Murphy, RL, Siddiqui, S, Toloba, Y, Konate, B, Diakite, M, Doumbia, S, Van Deun, A, Rigouts, L, Diallo, S & De Jong, BC 2020, 'Fluorescein diacetate and rapid molecular testing for the early identification of rifampicin resistance in Mali', International Journal of Tuberculosis and Lung Disease, vol. 24, no. 8, pp. 763-769. https://doi.org/10.5588/ijtld.19.0698

TY - JOUR

T1 - Fluorescein diacetate and rapid molecular testing for the early identification of rifampicin resistance in Mali

AU - Diarra, Bassirou

AU - Decroo, T.

AU - Somboro, A.

AU - Coulibaly, G.

AU - Tolofoudie, M.

AU - Kone, M.

AU - Degoga, B.

AU - Diallo, F.

AU - Togo, A. C.G.

AU - Sanogo, M.

AU - Sarro, Y. S.

AU - Cisse, A. B.

AU - Kodio, O.

AU - Baya, B.

AU - Kone, A.

AU - Maiga, M.

AU - Dao, S.

AU - Maiga, I. I.

AU - Murphy, R. L.

AU - Siddiqui, S.

AU - Toloba, Y.

AU - Konate, B.

AU - Diakite, M.

AU - Doumbia, S.

AU - Van Deun, A.

AU - Rigouts, L.

AU - Diallo, S.

AU - De Jong, B. C.

N1 - Funding Information: This work was done at the University Clinical Research Center of the University of Sciences, Techniques and Technologies of Bamako (USTTB), Mali, and was partially funded by the USTTB through NIH/R01 grant R01AI110386 and NIH/FIC D71 TWO10428-01A1, the Northwestern University (Chicago, IL, USA) through NIH/FIC D43 TW10350. The content of this publication does not necessarily reflect the views or policies of the US Department of Health and Human Services, nor does mention of trade names, commercial products, or organisations imply endorsement by the US Government. Funding Information: BD was supported by a TDR fellowship, TIMS ID B40072, the special programme for research and training in tropical diseases, co-sponsored by UNICEF, UNDP, World Bank and the WHO. Conflicts of interest: none declared. Publisher Copyright: © 2020 International Union against Tubercul. and Lung Dis.. All rights reserved.

PY - 2020/8/1

Y1 - 2020/8/1

N2 - BACKGROUND: Non-conversion on auramine smear microscopy indicates a lack of treatment response, possibly associated with initial rifampicin-resistant tuberculosis (RR-TB). However, dead bacteria still stain positive and may be detected. Fluorescein diacetate smear microscopy (FDA) shows live mycobacteria only. Therefore, we studied the potential of 2-month (2M) FDA for the identification of initial RRTB. METHODS: Between 2015 and 2018, we enrolled new smear-positive pulmonary TB patients from five local centres in Bamako, Mali. After baseline screening, sputum samples were collected at 1M, 2M, 5M and 18M. We used rpoB sequencing to identify initial RRTB. RESULTS: Of 1359 patients enrolled, 1019 (75%) had rpoB sequencing results. Twenty-six (2.6%, 95%CI: 1.7a-3.7) had mutations conferring rifampicin resistance. Most frequent rpoB mutations were located at the codons Asp435Val (42.4%) and Ser450Leu (34.7%). Among patients with initial RR-TB, 72.2% were FDAnegative at 2M (P Â 0.2). The positive and negative predictive value of 5M FDA for culture-based failure was respectively 20.0% and 94.7%. CONCLUSION: FDA did not identify the majority of patients with initial RR-TB or culture-based failure. As the full spectrum of mutations identified on sequencing was identified using Xpert, our data support its rapid universal implementation in Mali.

AB - BACKGROUND: Non-conversion on auramine smear microscopy indicates a lack of treatment response, possibly associated with initial rifampicin-resistant tuberculosis (RR-TB). However, dead bacteria still stain positive and may be detected. Fluorescein diacetate smear microscopy (FDA) shows live mycobacteria only. Therefore, we studied the potential of 2-month (2M) FDA for the identification of initial RRTB. METHODS: Between 2015 and 2018, we enrolled new smear-positive pulmonary TB patients from five local centres in Bamako, Mali. After baseline screening, sputum samples were collected at 1M, 2M, 5M and 18M. We used rpoB sequencing to identify initial RRTB. RESULTS: Of 1359 patients enrolled, 1019 (75%) had rpoB sequencing results. Twenty-six (2.6%, 95%CI: 1.7a-3.7) had mutations conferring rifampicin resistance. Most frequent rpoB mutations were located at the codons Asp435Val (42.4%) and Ser450Leu (34.7%). Among patients with initial RR-TB, 72.2% were FDAnegative at 2M (P Â 0.2). The positive and negative predictive value of 5M FDA for culture-based failure was respectively 20.0% and 94.7%. CONCLUSION: FDA did not identify the majority of patients with initial RR-TB or culture-based failure. As the full spectrum of mutations identified on sequencing was identified using Xpert, our data support its rapid universal implementation in Mali.

KW - FDA

KW - Mali

KW - rpoB

KW - sequencing

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DO - 10.5588/ijtld.19.0698

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VL - 24

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EP - 769

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

SN - 1027-3719

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ER -

Fluorescein diacetate and rapid molecular testing for the early identification of rifampicin resistance in Mali

Abstract

Keywords

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