{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T22:59:57Z","timestamp":1791845997486,"version":"4.3.4"},"reference-count":54,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T00:00:00Z","timestamp":1624492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Differences among <jats:italic>Mycobacterium tuberculosis<\/jats:italic> complex (MTC) species may predict drug resistance or treatment success. Thus, we optimised and deployed the genotype MTBC assay (gMTBC) to identify MTC to the species level, and then performed comparative genotypic drug\u2010susceptibility testing to anti\u2010tuberculosis drugs from direct sputum of patients with presumed multidrug\u2010resistant tuberculosis (MDR\u2010TB) by the MTBDRplus\/sl reference method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with positive Xpert<jats:sup>\u00ae<\/jats:sup> MTB\/RIF (Xpert) results were consented to provide early\u2010morning\u2010sputum for testing by the gMTBC and the reference MTBDRplus\/sl. Chi\u2010square or Fisher\u2019s exact test compared proportions. Modified Poisson regression modelled detection of MTC by gMTBC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 73 patients, 53 (73%) were male and had a mean age of 43 (95% CI; 40\u201345) years. In total, 34 (47%), 36 (49%) and 38 (55%) had positive gMTBC, culture and MTBDR respectively. Forty patients (55%) had low quantity MTC by Xpert, including 31 (78%) with a negative culture. gMTBC was more likely to be positive in patients with chest cavity 4.18 (1.31\u201313.32, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.016), high\u2010quantity MTC by Xpert 3.03 (1.35\u20136.82, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.007) and sputum smear positivity 1.93 (1.19\u20133.14, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.008). The accuracy of gMTBC in detecting MTC was 95% (95% CI; 86\u201398; \u03ba\u00a0=\u00a00.89) compared to MTBDRplus\/sl. All <jats:italic>M.\u00a0tuberculosis\/canettii<\/jats:italic> identified by gMTB were susceptible to fluoroquinolone and aminoglycosides\/capreomycin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The concordance between the gMTBC assay and MTBDRplus\/sl in detecting MTC was high but lagged behind the yield of Xpert MTB\/RIF. All <jats:italic>M.\u00a0tuberculosis\/canettii<\/jats:italic> were susceptible to fluoroquinolones, a core drug in MDR\u2010TB treatment regimens.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13638","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T17:30:17Z","timestamp":1623259817000},"page":"1057-1067","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["TB or not TB? Definitive determination of species within the <i>M<\/i><i>ycobacterium tuberculosis<\/i> complex in unprocessed sputum from adults with presumed multidrug\u2010resistant tuberculosis"],"prefix":"10.1111","volume":"26","author":[{"given":"Peter M.","family":"Mbelele","sequence":"first","affiliation":[{"name":"Kibong\u2019oto Infectious Diseases Hospital Kilimanjaro Tanzania"},{"name":"Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering Nelson Mandela African Institution of Science and Technology Arusha Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elingarami","family":"Sauli","sequence":"additional","affiliation":[{"name":"Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering Nelson Mandela African Institution of Science and Technology Arusha Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel A.","family":"Mpolya","sequence":"additional","affiliation":[{"name":"Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering Nelson Mandela African Institution of Science and Technology Arusha Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sagal Y.","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health University of Virginia Charlottesville VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kennedy K.","family":"Addo","sequence":"additional","affiliation":[{"name":"Department of Bacteriology Noguchi Memorial Institute for Medical Research, University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sayoki G.","family":"Mfinanga","sequence":"additional","affiliation":[{"name":"National Institute for Medical Research, Muhimbili Center Dar es salaam Tanzania"},{"name":"Muhimbili University of Health and Allied Sciences Dar es salaam Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott K.","family":"Heysell","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health University of Virginia Charlottesville VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stellah","family":"Mpagama","sequence":"additional","affiliation":[{"name":"Kibong\u2019oto Infectious Diseases Hospital Kilimanjaro Tanzania"},{"name":"Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering Nelson Mandela African Institution of Science and Technology Arusha Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,24]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Global tuberculosis report 2018","author":"World Health 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