Selected culture and drug-susceptibility testing methods for drug-resistantMycobacterium tuberculosisscreening in resource-constrained settings

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Evaluation of: Adikaram CP, Perera J, Wijesundera SS. The manual Mycobacteria Growth Indicator Tube and the Nitrate Reductase Assay for the rapid detection of rifampicin resistance of M. tuberculosis in low resource settings. BMC Infect. Dis. 12, 326 (2012).

The control of drug-resistant tuberculosis (TB) requires an accurate and a rapid diagnostic for the detection of critical patterns of drug resistance. Rifampicin resistance is a good predictor of the presence of multidrug-resistant TB. Traditionally, in vitro susceptibility methods for Mycobacterium tuberculosis are time consuming and laborious. More rapid methods are available but are very expensive for routine use in low-resource settings. According to the article under evaluation, the Manual Mycobacteria Growth Indicator Tube and Nitrate Reductase Assay, in liquid medium, agreed well with the agar proportion method for the rapid detection of rifampicin resistance in low-resource settings. The results of both susceptibility tests will be available in less than 2 weeks and the cost per test is low. Major efforts are needed to improve the diagnostic and treatment success rate among patients with drug-resistant TB. Since 2007, the WHO has promoted new diagnostic tests such as Xpert Mycobacterium tuberculosis/rifampicin; point-of-care tests are nowadays under development.

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