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We demonstrate that relying on one of these compensatory mutations (i.e.,\n                      <jats:italic toggle=\"yes\">ahpC<\/jats:italic>\n                      c\u221254t)\u2014rather than causative resistance mutations in\n                      <jats:italic toggle=\"yes\">katG<\/jats:italic>\n                      that\n                      <jats:italic toggle=\"yes\">ahpC<\/jats:italic>\n                      compensates for\u2014can result in systematic false-resistant results for isoniazid with the Cepheid Xpert MTB\/XDR and suboptimal treatment. The WHO mutation catalog should be refined to address this scenario.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.00265-25","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T09:01:47Z","timestamp":1745312507000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":3,"title":["The\n                    <i>ahpC<\/i>\n                    c\u221254t compensatory mutation is not always a valid surrogate for isoniazid resistance in\n                    <i>Mycobacterium tuberculosis<\/i>"],"prefix":"10.1128","volume":"69","author":[{"given":"Vikt\u00f3ria","family":"Sz\u00e9l","sequence":"first","affiliation":[{"name":"National Reference Laboratory for Mycobacteriology, National Koranyi Institute of Pulmonology","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8323-7019","authenticated-orcid":true,"given":"Jody E.","family":"Phelan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00a0jsq62","id-type":"ROR","asserted-by":"publisher"}],"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0099-903X","authenticated-orcid":true,"given":"Sophia B.","family":"Georghiou","sequence":"additional","affiliation":[{"name":"End TB Dx Consulting LLC","place":["San Diego, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Dolinger","sequence":"additional","affiliation":[{"name":"DLD IVD Consulting LLC","place":["Medway, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8985-9265","authenticated-orcid":true,"given":"Taane G.","family":"Clark","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00a0jsq62","id-type":"ROR","asserted-by":"publisher"}],"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6604-0684","authenticated-orcid":true,"given":"Stefan","family":"Niemann","sequence":"additional","affiliation":[{"name":"Molecular and Experimental Mycobacteriology, Research Center Borstel","place":["Borstel, Germany"]},{"id":[{"id":"https:\/\/ror.org\/028s4q594","id-type":"ROR","asserted-by":"publisher"}],"name":"German Center for Infection Research, Partner site Hamburg-L\u00fcbeck-Borstel-Riems","place":["Borstel, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilla K.","family":"L\u0151rinczi","sequence":"additional","affiliation":[{"name":"National Reference Laboratory for Mycobacteriology, National Koranyi Institute of Pulmonology","place":["Budapest, Hungary"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0232-846X","authenticated-orcid":true,"given":"Claudio U.","family":"K\u00f6ser","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/013meh722","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Genetics, University of Cambridge","place":["Cambridge, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003008"},{"key":"e_1_3_3_3_2","volume-title":"WHO operational handbook on tuberculosis: module 3: diagnosis: rapid diagnostics for tuberculosis detection","author":"World Health Organization","year":"2024","unstructured":"World Health Organization. 2024. 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