From GeneXpert to Whole Genome Sequencing (WGS): The Evolution of Detecting rpoB Resistance

Abstract

This study aims to review the development of technologies for detecting rpoB gene mutations associated with rifampicin resistance in Mycobacterium tuberculosis. The method employed was a literature review of various scientific publications collected from sources such as Google Scholar, Scopus, and SINTA. The results of the study indicate significant technological evolution from conventional methods, such as the Niehl-Neelsen stain and culture, toward molecular-based platforms. GeneXpert MTB/RIF offers the advantage of rapid results less than 2 hours with high sensitivity, but has limitations in specifically detecting the RRDR region. Conversely, Whole Genome Sequencing (WGS) and Next-Generation Sequencing (NGS) provide comprehensive nucleotide-level resolution, enabling the detection of mutations outside traditional hotspots as well as heteroresistance conditions. Although GeneXpert is highly superior for rapid diagnosis, the integration of WGS into the national health system is crucial for comprehensive genomic surveillance and improving the precision of TB therapy in Indonesia