Drug-susceptibility testing in tuberculosis: methods and reliability of results
TLDR
In vitro criteria of resistance for susceptibility testing should be carefully determined with representative clinical samples of Mycobacterium tuberculosis isolated from patients never treated with any antituberculosis drug, and from patients having failed treatment with a regimen containing the tested drug; DST should then be carefully standardised to obtain reproducible results.Abstract:
The demand for reliable drug-susceptibility testing (DST) increases with the expansion of antituberculosis drug-resistance surveillance, and with the need for an appropriate treatment of multidrug-resistant tuberculosis, whose incidence gradually increases in many parts of the world. However, the reliability of DST results obtained through widely used methods does not meet acceptable levels, except for DST to isoniazid and rifampicin. In general, susceptibility results are highly predictable, while resistance results show low predictive values when the resistance prevalence is <10%. Poor reliability stems from a weak correlation with clinical response and a low reproducibility due to the poor standardisation of the complex and fragile test procedures. Therefore, in vitro criteria of resistance for susceptibility testing should be carefully determined with representative clinical samples of Mycobacterium tuberculosis isolated from patients never treated with any antituberculosis drug, and from patients having failed treatment with a regimen containing the tested drug; DST should then be carefully standardised to obtain reproducible results. The critical concentration of some drugs is close to the minimal inhibitory concentration for wild susceptible strains and, thus, drug-susceptibility testing is prone to yield poorly reproducible results. These issues call for physicians' attention when using the results from drug-susceptibility testing for case management.read more
Citations
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Journal ArticleDOI
WHO guidelines for the programmatic management of drug-resistant tuberculosis: 2011 update
Dennis Falzon,Ernesto Jaramillo,Holger J. Schünemann,Matthew Arentz,Melissa Bauer,Jaime Bayona,Léopold Blanc,Jose A. Caminero,Charles L. Daley,Chris Duncombe,Christopher Fitzpatrick,Agnes Gebhard,Haileyesus Getahun,Myriam Henkens,Timothy H. Holtz,J. Keravec,S. Keshavjee,Aamir J. Khan,R. Kulier,Vaira Leimane,Christian Lienhardt,Chunling Lu,Mar'iandyshev Ao,Giovanni Battista Migliori,Fuad Mirzayev,Carole D. Mitnick,Paul Nunn,G. Nwagboniwe,Olivia Oxlade,Domingo Palmero,Patricia B Pavlinac,M. I. D. Quelapio,Mario C. Raviglione,Michael Rich,S. Royce,Sabine Rüsch-Gerdes,A. Salakaia,R. Sarin,Delphine Sculier,Francis Varaine,Marco Vitoria,Judd L. Walson,Fraser Wares,Karin Weyer,Richard A. White,Matteo Zignol +45 more
TL;DR: The guidelines promote the early use of antiretroviral agents for TB patients with HIV on second-line drug regimens and systems that primarily employ ambulatory models of care are recommended over others based mainly on hospitalisation.
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International standards for tuberculosis care.
TL;DR: The International Standards for Tuberculosis Care (ISTC) describe a widely endorsed level of care that all practitioners should seek to achieve in managing individuals who have, or are suspected of having, tuberculosis.
Journal ArticleDOI
Best drug treatment for multidrug-resistant and extensively drug-resistant tuberculosis
TL;DR: The evidence available for each drug is described and the basis for recommendations for the treatment of patients with MDR and XDR tuberculosis is discussed, which is the combination of at least four drugs to which the Mycobacterium tuberculosis isolate is likely to be susceptible.
Journal ArticleDOI
The epidemiology, pathogenesis, transmission, diagnosis, and management of multidrug-resistant, extensively drug-resistant, and incurable tuberculosis
Keertan Dheda,Tawanda Gumbo,Gary Maartens,Kelly E. Dooley,Ruth McNerney,Megan Murray,Jennifer Furin,Edward A. Nardell,Leslie London,Erica Lessem,Grant Theron,Paul D. van Helden,Stefan Niemann,Matthias Merker,David W. Dowdy,Annelies Van Rie,Annelies Van Rie,Gilman Kit Hang Siu,Jotam G. Pasipanodya,Camilla Rodrigues,Taane G. Clark,F. A. Sirgel,Aliasgar Esmail,Hsien-Ho Lin,Sachin R Atre,H. Simon Schaaf,Kwok Chiu Chang,Christoph Lange,Payam Nahid,Zarir F Udwadia,C. Robert Horsburgh,Gavin J. Churchyard,Gavin J. Churchyard,Dick Menzies,Anneke C. Hesseling,Eric L. Nuermberger,Helen McIlleron,Kevin P. Fennelly,Eric Goemaere,Ernesto Jaramillo,Marcus Low,Carolina Morán Jara,Nesri Padayatchi,Robin M. Warren +43 more
TL;DR: Several lines of evidence suggest that alternative mechanisms-including pharmacokinetic variability, induction of efflux pumps that transport the drug out of cells, and suboptimal drug penetration into tuberculosis lesions-are likely crucial to the pathogenesis of drug-resistant tuberculosis.
Journal ArticleDOI
Management of patients with multidrug-resistant/extensively drug-resistant tuberculosis in Europe: a TBNET consensus statement
Christoph Lange,Ibrahim Abubakar,Jan-Willem C. Alffenaar,Graham H. Bothamley,Jose A. Caminero,Anna Cristina Calçada Carvalho,Kwok Chiu Chang,Luigi Codecasa,Ana Maria Correia,Valeriu Crudu,Peter Davies,Martin Dedicoat,Francis Drobniewski,Raquel Duarte,Cordula Ehlers,Connie Erkens,Delia Goletti,Gunar Günther,Elmira Ibraim,Beate Kampmann,Liga Kuksa,Wiel C M de Lange,Frank van Leth,Jan Van Lunzen,Alberto Matteelli,Dick Menzies,Ignacio Monedero,Elvira Richter,Sabine Rüsch-Gerdes,Andreas Sandgren,Anna Scardigli,Alena Skrahina,Enrico Tortoli,Grigory V. Volchenkov,Dirk Wagner,Marieke J. van der Werf,Bhanu Williams,Wing Wai Yew,Jean-Pierre Zellweger,Daniela Maria Cirillo +39 more
TL;DR: This document summarises the current knowledge on the prevention, diagnosis and treatment of adults and children with MDR/XDR-TB and their contacts, and provides expert consensus recommendations on questions where scientific evidence is still lacking.
References
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Book
Manual of clinical microbiology
TL;DR: A collaborative team of editors and authors from around the world revised the Manual to include the latest applications of genomics and proteomics, producing an authoritative work of two volumes filled with current findings regarding infectious agents, leading-edge diagnostic methods, laboratory practices, and safety guidelines.
Journal ArticleDOI
Resazurin microtiter assay plate: Simple and inexpensive method for detection of drug resistance in Mycobacterium tuberculosis
Juan Carlos Palomino,Anandi Martin,Mirtha Camacho,Humberto Guerra,Jean Swings,Françoise Portaels +5 more
TL;DR: This method for detecting multidrug-resistant Mycobacterium tuberculosis by using a reduction of resazurin is simple, inexpensive, and rapid and might be used with other antituberculosis drugs.
Journal Article
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G. Canetti,Wallace Fox,A. Khomenko,H. T. Mahler,N.K. Menon,Denis A. Mitchison,N. Rist,N. A. Šmelev +7 more
TL;DR: Describing of the sensitivity tests used by the Medical Research Council of Great Britain for first- and second-line drugs, the two main variants of the proportion method developed by the Institut Pasteur, Paris, and a method for calibrating sensitivity tests are contained in the present paper.
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