Rapid diagnostics of tuberculosis and drug resistance in the industrialized world: clinical and public health benefits and barriers to implementation

BMC Medicine

Olga Ignatyeva²  Irina Kontsevaya²  Nicola Casali³  Yanina Balabanova³  Horst Maxeiner⁴  Vladyslav Nikolayevskyy³  Francis Drobniewski¹ 

[1] Imperial College, London W12 0NN, UK;Samara Oblast TB Service, 154 Novo-Sadovaya Street, Samara, Russian Federation;Queen Mary University of London, 2 Newark Street, London E1 2AT, UK;Public Health England National Mycobacterium Reference Laboratory, 2 Newark Street, London E1 2AT, UK

关键词: Whole genome sequencing;    Public health;    Tuberculosis;    Drug resistance;    Diagnosis;   

Others  :  855736
DOI  :  10.1186/1741-7015-11-190

 received in 2013-05-03, accepted in 2013-08-02,  发布年份 2013

【 摘 要 】

In this article, we give an overview of new technologies for the diagnosis of tuberculosis (TB) and drug resistance, consider their advantages over existing methodologies, broad issues of cost, cost-effectiveness and programmatic implementation, and their clinical as well as public health impact, focusing on the industrialized world. Molecular nucleic-acid amplification diagnostic systems have high specificity for TB diagnosis (and rifampicin resistance) but sensitivity for TB detection is more variable. Nevertheless, it is possible to diagnose TB and rifampicin resistance within a day and commercial automated systems make this possible with minimal training. Although studies are limited, these systems appear to be cost-effective. Most of these tools are of value clinically and for public health use. For example, whole genome sequencing of Mycobacterium tuberculosis offers a powerful new approach to the identification of drug resistance and to map transmission at a community and population level.

【 授权许可】

   
2013 Drobniewski et al.; licensee BioMed Central Ltd.

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