title: Diagnostic accuracy and reproducibility of WHO-endorsed phenotypic drug susceptibility testing methods for first-line and second-line antituberculosis drugs.
abstract: In an effort to update and clarify policies on tuberculosis drug susceptibility testing (DST), the World Health Organization (WHO) commissioned a systematic review evaluating WHO-endorsed diagnostic tests. We report the results of this systematic review and meta-analysis of the diagnostic accuracy and reproducibility of phenotypic DST for first-line and second-line antituberculosis drugs. This review provides support for recommended critical concentrations for isoniazid and rifampin in commercial broth-based systems. Further studies are needed to evaluate critical concentrations for ethambutol and streptomycin that accurately detect susceptibility to these drugs. Evidence is limited on the performance of DST for pyrazinamide and second-line drugs.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington, USA. dhorne@u.washington.edu
authors.forename: David J
authors.initials: DJ
authors.lastname: Horne
authors.forename: Lancelot M
authors.initials: LM
authors.lastname: Pinto
authors.forename: Matthew
authors.initials: M
authors.lastname: Arentz
authors.forename: S-Y Grace
authors.initials: SY
authors.lastname: Lin
authors.forename: Edward
authors.initials: E
authors.lastname: Desmond
authors.forename: Laura L
authors.initials: LL
authors.lastname: Flores
authors.forename: Karen R
authors.initials: KR
authors.lastname: Steingart
authors.forename: Jessica
authors.initials: J
authors.lastname: Minion
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods / Q000592:standards; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy; D014944:World Health Organization
chemical_list: D000995:Antitubercular Agents