title: Emerging technologies for monitoring drug-resistant tuberculosis at the point-of-care.
abstract: Infectious diseases are the leading cause of death worldwide. Among them, tuberculosis (TB) remains a major threat to public health, exacerbated by the emergence of multiple drug-resistant (MDR) and extensively drug-resistant (XDR) Mycobacterium tuberculosis (Mtb). MDR-Mtb strains are resistant to first-line anti-TB drugs such as isoniazid and rifampicin; whereas XDR-Mtb strains are resistant to additional drugs including at least to any fluoroquinolone and one of the second-line anti-TB injectable drugs such as kanamycin, capreomycin, or amikacin. Clinically, these strains have significantly impacted the management of TB in high-incidence developing countries, where systemic surveillance of TB drug resistance is lacking. For effective management of TB on-site, early detection of drug resistance is critical to initiate treatment, to reduce mortality, and to thwart drug-resistant TB transmission. In this review, we discuss the diagnostic challenges to detect drug-resistant TB at the point-of-care (POC). Moreover, we present the latest advances in nano/microscale technologies that can potentially detect TB drug resistance to improve on-site patient care.
authors.affiliation: Singapore Immunology Network (SIgN), Agency for Science Technology and Research (A*STAR), Singapore.
authors.forename: Vigneshwaran
authors.initials: V
authors.lastname: Mani
authors.affiliation: Demirci Bio-Acoustic-MEMS in Medicine (BAMM) Laboratory, Stanford University School of Medicine, Radiology Department, Canary Center at Stanford for Cancer Early Detection, Palo Alto, CA, USA.
authors.forename: ShuQi
authors.initials: S
authors.lastname: Wang
authors.affiliation: Demirci Bio-Acoustic-MEMS in Medicine (BAMM) Laboratory, Stanford University School of Medicine, Radiology Department, Canary Center at Stanford for Cancer Early Detection, Palo Alto, CA, USA.
authors.forename: Fatih
authors.initials: F
authors.lastname: Inci
authors.affiliation: Singapore Immunology Network (SIgN), Agency for Science Technology and Research (A*STAR), Singapore; University Hospital Basel, Basel, Switzerland.
authors.forename: Gennaro
authors.initials: G
authors.lastname: De Libero
authors.affiliation: Singapore Immunology Network (SIgN), Agency for Science Technology and Research (A*STAR), Singapore. Electronic address: Amit_Singhal@immunol.a-star.edu.sg.
authors.forename: Amit
authors.initials: A
authors.lastname: Singhal
authors.affiliation: Demirci Bio-Acoustic-MEMS in Medicine (BAMM) Laboratory, Stanford University School of Medicine, Radiology Department, Canary Center at Stanford for Cancer Early Detection, Palo Alto, CA, USA. Electronic address: utkan@stanford.edu.
authors.forename: Utkan
authors.initials: U
authors.lastname: Demirci
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage / Q000494:pharmacology*; D042241:Early Diagnosis; D054908:Extensively Drug-Resistant Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D055616:Microtechnology / Q000379:methods; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D036103:Nanotechnology / Q000379:methods; D019095:Point-of-Care Systems; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents
keywords: Diagnostics; Drug resistance; Nano/microscale technologies; Point-of-care; Tuberculosis