Molecular Diagnostics for Mycobacterium tuberculosis Infection

Annu Rev Med. 2019 Jan 27:70:77-90. doi: 10.1146/annurev-med-040717-051502. Epub 2018 Aug 20.

Abstract

Resistance to antimycobacterial drugs is a major barrier to effective treatment of Mycobacterium tuberculosis infection. Molecular diagnostic techniques based on the association between specific gene mutations and phenotypic resistance to certain drugs offer the opportunity to rapidly ascertain whether drug resistance is present and to alter treatment before further resistance develops. Current barriers to successful implementation of rapid diagnostics include imperfect knowledge regarding the full spectrum of mutations associated with resistance, limited utilization of molecular diagnostics where they are most needed, and the requirement for specialized laboratory facilities to perform molecular testing. Further understanding of genotypic-phenotypic correlates of resistance and streamlined implementation platforms will be necessary to optimize the public health impact of molecular resistance testing for M. tuberculosis.

Keywords: bacterial; drug resistance; early diagnosis; molecular diagnostic techniques; tuberculosis.

Publication types

  • Review

MeSH terms

  • Antitubercular Agents / therapeutic use*
  • Drug Resistance, Bacterial / genetics*
  • Female
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Mycobacterium tuberculosis / drug effects*
  • Mycobacterium tuberculosis / genetics*
  • Needs Assessment
  • Pathology, Molecular / methods*
  • Prognosis
  • Tuberculosis / drug therapy*
  • Tuberculosis / genetics

Substances

  • Antitubercular Agents