Clinical implications of molecular drug resistance testing for Mycobacterium tuberculosis: a 2023 TBnet/RESIST-TB consensus statement. Issue 4 (April 2023)

• Record Type: Journal Article
• Authors: Domínguez, José; Boeree, Martin J; Cambau, Emmanuelle; Chesov, Dumitru; Conradie, Francesca; Cox, Vivian; Dheda, Keertan; Dudnyk, Andrii; Farhat, Maha R; Gagneux, Sebastien; Grobusch, Martin P; Gröschel, Matthias I; Guglielmetti, Lorenzo; Kontsevaya, Irina; Lange, Berit; van Leth, Frank; Lienhardt, Christian; Mandalakas, Anna M; Maurer, Florian P; Merker, Matthias; Miotto, Paolo; Molina-Moya, Barbara; Morel, Florence; Niemann, Stefan; Veziris, Nicolas; Whitelaw, Andrew; Horsburgh, Charles R; Lange, Christoph; Domínguez, Jose; Boeree, Martin J.; Cambau, Emmanuelle; Chesov, Dumitru; Conradie, Francesca; Cox, Vivian; Dheda, Keertan; Dudnyk, Andrii; Farhat, Maha R.; Gagneux, Sebastien; Grobusch, Martin P.; Gröschel, Matthias I.; Guglielmetti, Lorenzo; Kontsevaya, Irina; Lange, Berit; van Leth, Frank; Lienhardt, Christian; Mandalakas, Anna Maria; Maurer, Florian; Merker, Matthias; Miotto, Paolo; Molina-Moya, Barbara; Morel, Florence; Niemann, Stefan; Veziris, Nicolas; Whitelaw, Andrew; Horsburgh, Charles Robert; Lange, Christoph;
• Is Part Of: Lancet infectious diseases. Volume 23:Issue 4(2023)
• Page Start: e122
• Page End: e137
• Publication Date: 2023-04
• Subjects: Communicable diseases -- Periodicals; Infection -- Periodicals; Communicable Diseases -- Periodicals; Infection -- Periodicals; Maladies infectieuses -- Périodiques; Infection -- Périodiques; Communicable diseases; Infection; Periodicals; 616.905
• DOI: 10.1016/S1473-3099(22)00875-1
• Languages: English
• ISSNs: 1473-3099

Abstract

Summary: Drug-resistant tuberculosis is a substantial health-care concern worldwide. Despite culture-based methods being considered the gold standard for drug susceptibility testing, molecular methods provide rapid information about the Mycobacterium tuberculosis mutations associated with resistance to anti-tuberculosis drugs. This consensus document was developed on the basis of a comprehensive literature search, by the TBnet and RESIST-TB networks, about reporting standards for the clinical use of molecular drug susceptibility testing. Review and the search for evidence included hand-searching journals and searching electronic databases. The panel identified studies that linked mutations in genomic regions of M tuberculosis with treatment outcome data. Implementation of molecular testing for the prediction of drug resistance in M tuberculosis is key. Detection of mutations in clinical isolates has implications for the clinical management of patients with multidrug-resistant or rifampicin-resistant tuberculosis, especially in situations when phenotypic drug susceptibility testing is not available. A multidisciplinary team including clinicians, microbiologists, and laboratory scientists reached a consensus on key questions relevant to molecular prediction of drug susceptibility or resistance to M tuberculosis, and their implications for clinical practice. This consensus document should help clinicians in the management of patients with tuberculosis, providing guidance for the design of treatment regimens and optimising outcomes.