Improving the diagnosis of tuberculosis: old and new laboratory tools

Figures & data

Figure 1. Workflow for the processing of mycobacterial samples. DST = drug susceptibility testing.

Table 1. Advantages and disadvantages of molecular tests, used in the diagnosis/detection of drug resistance for TB.

Molecular Test	Advantages	Disadvantages	References
GeneXpert Systems (Cepheid)	Low complexity Can be used in resource poor settings Detection of drug resistance	Sputum-based test	[22]
Truenat MTB system (MolBio)	Can be used near patient and in resource poor settings Battery operated Minimal training required Detection of drug resistance	Sputum-based test Low sensitivity in smear-negative, culture-positive isolates	[6,22]
Genotype LPA (Bruker)	Increased species-specific data Detection of drug resistance	Low sensitivity in extra pulmonary TB patients High cost Requires trained personnel and infrastructure	[20]
BD MAX platform (Becton Dickinson)	Entire testing process requires a single platform All reagents required for testing are incorporated onto the testing strip Detection of drug resistance	Report generated does not provide any details on the resistance mutations detected	[23]
Real-Time MTB RIF/INH Resistance (RT MTB RIF/INH) (Abbott Molecular)	Short ‘hands-on’ time Detection of drug resistance	Long processing time	[23]
cobas MTB and cobas MTB-RIF/INH (Roche)	Entire testing process requires a single platform Detection of drug resistance	Report generated does not provide any details on the resistance mutations detected	[23]
Genoscholar PZA-TB II (Nipro)	Detection of PZA drug resistance performs well for PZA resistance compared with phenotypic DST	Performance data is limited in primary specimen For use with positive cultures only	[24]
WGS	Full genome sequence Prespecified targets not required Able to detect rare/new mutations inferring resistance	Expensive Requires cultured isolates Complicated bioinformatics, need trained personnel	[25]

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