Comparison Of Middlebrook 7H9 Culture and Xpert MTB/XDR for Detecting Isoniazid and Fluoroquinolone Resistance
DOI:
https://doi.org/10.24269/ijhs.v10i02.13441Abstract
Drug-resistant tuberculosis (DR-TB) remains a major public health challenge in Indonesia, necessitating rapid and accurate detection of resistance to key anti-tuberculosis drugs. This quantitative descriptive analytic cross-sectional study evaluated the concordance of Mycobacterium tuberculosis resistance detection between phenotypic Middlebrook 7H9 liquid culture and genotypic TCM XDR in 44 DR-TB patients, focusing on isoniazid (H) and fluoroquinolone/levofloxacin (FQ/Lfx) resistance. Data were analyzed using the McNemar test methode. High-concentration H resistance was detected in 68.2% by culture and 65.9% by TCM XDR, while FQ/Lfx resistance was identified in 18.2% and 15.9%, respectively. No significant differences were observed between methods for high-concentration H and FQ/Lfx resistance detection (P=1.000), indicating high concordance with cappa values 0,74 isoniazid for and 0,86 for FQ/Lfx resistance. In contrast, a significant discrepancy was found for low-concentration H resistance (P=0.001), with a discordance rate of 25%, potentially attributable to HA promoter mutations not included in the TCM XDR panel or non-genetic adaptive mechanisms.
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