The performance of A rpob gene mutation linked to A resistant to rifampicin mycobacterium tuberculosis isolate from an Indonesian referral hospital

Introduction: Indonesia has the world's second-highest tuberculosis and is one of the 30 countries with an increased MDR/RR TB burden. Even though the number of people with tuberculosis is rising every year, several cases of latent or active tuberculosis remain unreported. Microscopy has its limitations, and factors such as quality sample, quality smear, bacterial load, and experience of reading AFB influence the sensitivity of the test. Utilizing a quick, point-of-care testing system based on molecular techniques can increase the sensitivity of tuberculosis early diagnosis. Cepheid Xpert ®MTB/RIF is Indonesia's most widely utilized molecular technology. It is a nested real-time PCR diagnostic device that is cartridge-based and semiquantitative. In the TB complex of Mycobacterium tuberculosis, it identifies alterations in the RNA polymerase (rpoB) gene beta-subunit that result in rifampicin resistance (RR). By utilizing the Xpert ® MTB/RIF assay at Soetomo General Hospital, one of Indonesia's primary tertiary referral hospitals, the current study seeks to improve our knowledge of the prevalence of rpoB gene mutations in individuals with tuberculosis. Methods: Between January 2021 and December 2021, Soetomo General Hospital used the Xpert®MTB/RIF system to screen sputum and extrapulmonary specimens from 3584 for tuberculosis. Results: Of the 665 samples, 18,5% tested positive for M. tuberculosis, with 7.6% (51 out of 665) showing resistance to Rifampicin Rifampicin compounds at codons 529–533 (probe E) of the rpoB gene were detected in 56.8% (29/51) of rifampicin-resistant tuberculosis (RR-TB) samples. And then Probe D (19.6%). 7.8% for probes A and B, respectively (5.8%). Probe C did not exhibit any mutations. On the other hand, two samples revealed two mutations in probes D and E, while among 13.7% (7/51) of RR TB samples, no mutations in the probe type were observed. Conclusion: The Xpert®MTB/RIF system is a compassionate, fast, accurate, and efficient diagnostic tool for RR-TB, tuberculosis, and the molecular epidemiology of mutations associated with rifampin resistance.