Xpert MTB/RIF Ultra resistant and MTBDRplus susceptible rifampicin results in people with tuberculosis: utility of FluoroType MTBDR and deep sequencing

Xpert MTB/RIF Ultra (Ultra)-detected rifampicin-resistance is often programmaticallyconfirmed using MTBDRplus. There are limited data on discordant results, including when analysedusing FluoroType MTBDR (FT-MTBDR) and targeted deep sequencing (TDS).Isolates from people with Ultra rifampicin-resistant sputum and MTBDRplus rifampicin-susceptible isolates were identified from a South African programmatic laboratory. FT-MTBDR andTDS single molecule-overlapping reads (SMOR; rpoB, inhA, katG) on isolate DNA were done, withSMOR as a reference standard.