Detection of drug resistance in Mycobacterium tuberculosis: Methods, principles and applications

摘要

The growing emergence of multidrug resistant tuberculosis (MDR-TB) strains is obstructing efforts for the control and management of TB. Proper management of MDR-TB relies on early recognition of drug resistance followed by timely treatment initiation. Several diagnostic methods, both phenotypic and molecular, have been developed in last few years for rapid identification of drug resistant (DR)-TB. Revised national tuberculosis control programmes (RNTPs) may find it tough to choose from the puzzling variety of rapid tests. Here, we present an outline of the available methods, discussing their basis, advantages and deficiencies. Mycobacterium tuberculosis (MTB) strains that were resistant to streptomycin (STR) appeared just after the introduction of the drug for treatment of tuberculosis (TB) in 1944. The potent antitubercular action of isoniazid (INH) was first observed in the year 1951. Shortly after the introduction of INH the first resistant strains were isolated from patients treated by INH monotherapy. The most effective first line antutubercular drug rifampicin (RIF) was introduced in 1967 and resistance to it has also emerged. Together with INH, RIF is the backbone of TB treatment.