First detection of a Mycobacterium tuberculosis XDR clinical isolate harbouring an RpoB I491F mutation in a Ukrainian patient treated in Germany, October 2023

Euro Surveill. 2024 Jul;29(28):2400420. doi: 10.2807/1560-7917.ES.2024.29.28.2400420.

Abstract

This report documents the case of a Ukrainian patient infected with an extensively drug-resistant (XDR) lineage 2 Mycobacterium tuberculosis strain harbouring the rifampicin resistance mutation RpoB I491F. This mutation is not detected by routine molecular WHO-recommended rapid diagnostics, complicating the detection and treatment of these strains. The occurrence of such mutations underscores the need for enhanced diagnostic techniques and tailored treatment regimens, especially in eastern Europe where lineage 2 strains and XDR-tuberculosis are prevalent.

Keywords: GeneXpert; I491F; MDR-TB; Rifampicin; Ukraine; XDR-TB.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antitubercular Agents* / therapeutic use
  • Bacterial Proteins* / genetics
  • DNA-Directed RNA Polymerases* / genetics
  • Extensively Drug-Resistant Tuberculosis* / diagnosis
  • Extensively Drug-Resistant Tuberculosis* / drug therapy
  • Extensively Drug-Resistant Tuberculosis* / microbiology
  • Female
  • Germany
  • Humans
  • Microbial Sensitivity Tests
  • Mutation*
  • Mycobacterium tuberculosis* / drug effects
  • Mycobacterium tuberculosis* / genetics
  • Mycobacterium tuberculosis* / isolation & purification
  • Rifampin* / therapeutic use
  • Ukraine

Substances

  • Antitubercular Agents
  • Bacterial Proteins
  • DNA-Directed RNA Polymerases
  • Rifampin
  • rpoB protein, Mycobacterium tuberculosis