Utilization of whole genome sequencing for resolution of discrepant Mycobacterium tuberculosis drug susceptibility results: A case report

被引：2

作者：

Realegeno, Susan ^{[1
,4
]}

Adeyiga, Oladunni ^{[2
]}

Winston, Drew J. ^{[3
]}

Beaird, Omer E. ^{[2
]}

Garner, Omai B. ^{[1
]}

Yang, Shangxin ^{[1
]}

机构：

[1] Univ Calif Los Angeles, UCLA Clin Microbiol Lab, Dept Pathol & Lab Med, Los Angeles, CA USA

[2] Univ Calif Los Angeles, Dept Med, Div Infect Dis, Los Angeles, CA 90024 USA

[3] Univ Calif Los Angeles, Dept Med, Div Hematol & Oncol, Los Angeles, CA 90024 USA

[4] Quest Diagnost Infect Dis, San Juan Capistrano, CA USA

来源：

IDCASES | 2021年 / 26卷

关键词：

Mycobacterium tuberculosis; Whole genome sequencing; Drug resistance prediction; DST; RESISTANCE; PERFORMANCE;

D O I：

10.1016/j.idcr.2021.e01308

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

A 44-year-old woman undergoing therapy for acute promyelocytic leukemia (APL) developed disseminated tuberculosis. Mycobacterium tuberculosis (TB) was isolated from the blood and sputum. Initial drug sus-ceptibility testing (DST) of the blood isolate revealed resistance to isoniazid and ethambutol but the sputum isolate showed no resistance. Due to drug resistance concerns, the patient was treated with multiple second and third-line drugs, and suffered from drug side effects. To further investigate the DST discrepancies, whole genome sequencing (WGS) was performed on both isolates. No known resistance mutations to first line or second line drugs were identified in either isolate, which was confirmed by additional susceptibility testing performed by a different reference laboratory and the California Department of Public Health (CDPH) laboratory. Treatment was reduced to a simpler and less toxic regimen due to these investigations. WGS is shown to be a valuable tool for resolving discordant phenotypic DST results of TB isolates and has the potential to provide accurate and timely results guiding appropriate therapy in the clinical setting. (C) 2021 The Authors. Published by Elsevier Ltd.

引用

页数：4

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