Tuberculosis (TB) is one of the leading causes of morbidity and mortality worldwide, with an estimated 10.8 million new cases in 2023. Southeast Asia accounted for the highest proportion at 45 % [1], with the Philippines contributing 6.8 % of the global incidence.

Since the development of the GeneXpert MTB/RIF assay, time to TB diagnosis has improved significantly; it is now the preferred initial diagnostic test for TB and rifampicin-resistance detection among individuals with signs and symptoms of pulmonary TB [2,3].

Despite recent advances in these rapid point of care tests, current literature on Xpert testing fails to include the relevance of rifampin (RIF) resistance indeterminate results. According to the World Health Organization (WHO), the effect of indeterminate, non-determinate, or invalid results on diagnostic accuracy and patient outcomes is an important research gap that must be addressed [4]. In this study, we sought to determine the implication of, and describe patients with Xpert RIF-indeterminate results.