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European Journal of Clinical Microbiology & Infectious Diseases
Erschienen in: European Journal of Clinical Microbiology & Infectious Diseases 3/2020

30.10.2019 | Review

Non-commercial phenotypic assays for the detection of Mycobacterium tuberculosis drug resistance: a systematic review

verfasst von: Irina Kontsevaya, Jim Werngren, Yen Holicka, Kadri Klaos, Anh Tran, Vladyslav Nikolayevskyy

Erschienen in: European Journal of Clinical Microbiology & Infectious Diseases | Ausgabe 3/2020

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Abstract

Several rapid non-commercial culture-based methods and assays for drug susceptibility testing (DST) of Mycobacterium tuberculosis have emerged over the last decades. The aim of the current review was to summarise evidence on the performance of microscopic observation of drug susceptibility (MODS), thin-layer agar (TLA) and colorimetric redox-indicator (CRI) assays for detection of resistance to first- and second-line anti-tuberculosis (TB) drugs. Forty-three publications satisfying selection criteria were selected for data extraction. MODS and CRI assays demonstrated pooled sensitivity and specificity of > 93% for the detection of resistance to rifampicin and isoniazid and confirmed their utility for an accurate detection of multidrug-resistant TB (MDR-TB) in various settings. Sensitivity and specificity values for indirect DST for ethambutol (EMB) using CRI assays were 94.0% and 82.0%, respectively, suggesting that CRIs could be used to rule out resistance to EMB. Performance for other drugs varied more substantially across the reports. There was no sufficient evidence on the performance of the TLA assay for making any conclusion on its utility for DST. Our data suggests that non-commercial assays could be used for a rapid and accurate DST in settings where the use of commercial World Health Organization-endorsed assays could be limited due to a variety of reasons including limited resources, laboratory facilities or trained personnel. While inexpensive and easy-to-perform MODS and TLA assays can be used in low-income settings, using CRI assays for determination of minimal inhibitory concentrations may be implemented in middle- and high-income countries with high MDR-TB burden to guide clinical management of TB patients.
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Metadaten
Titel
Non-commercial phenotypic assays for the detection of Mycobacterium tuberculosis drug resistance: a systematic review
verfasst von
Irina Kontsevaya
Jim Werngren
Yen Holicka
Kadri Klaos
Anh Tran
Vladyslav Nikolayevskyy
Publikationsdatum
30.10.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Clinical Microbiology & Infectious Diseases / Ausgabe 3/2020
Print ISSN: 0934-9723
Elektronische ISSN: 1435-4373
DOI
https://doi.org/10.1007/s10096-019-03723-8

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