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Recap of the 2nd UNITE4TB webinar: Expert interview with microbiologists on TB diagnostics
On Wednesday 4 May, UNITE4TB held its second webinar – part of a series of online events organized by Consortium partners, Instituto de Saúde Pública da Universidade do Porto (ISPUP) and the European Respiratory Society (ERS).
The webinar was focused on tuberculosis (TB) diagnostics and the challenges of aligning diagnostic tests for new treatment regimens. The session featured a comprehensive presentation by Dr. Daniela Cirillo of Università Vita-Salute San Raffaele, who is leading the Consortium's microbiology Work Package (WP). Amongst other things, her presentation covered the current WHO-approved TB diagnostics, providing insight into the strengths and limitations of available diagnostics for TB. Attention was also given to the future of TB diagnostics, taking into account lessons learned from the COVID-19 experience.
Dr. Cirillo’s presentation emphasized how important it is to have molecular tools based on sequencing for identifying drug resistance. These tools should be available before regimens are approved, and innovative strategies should allow for the implementation of these tools in all settings.
Other key take-home messages:
- Drug susceptibility testing is essential to treatment. However, its coverage for first- and second-line drugs is low, and there are no available tests for newly developed drugs
- Phenotypic testing for group A drugs is available in high-income countries but is still limited
- Line probe assay is an excellent screening tool when regimens contain fluoroquinolones and injectables
- Currently, there are no WHO-recommended methods for newer and repurposed drugs. Next-generation sequencing represents the most promising strategy
- A mutation catalog is available from the WHO, however, it has limitations due to the low number of available resistance strains to new drugs. An updated version of the catalog will address specific mutations of these drugs
- Notably, testing for a critical concentration is not sufficient. Testing the minimum inhibitory concentration of the drugs is needed, and the plates used for testing should contain new drugs
- Precision medicine and molecular tools will drastically improve patient management
Dr. Cirillo’s presentation was followed by a panel discussion chaired by Consortium partners Prof. Dr. Raquel Duarte (ISPUP) and Prof. Dr. Christoph Lange (Research Center Borstel). They were joined by two members of the UNITE4TB Young Investigator Group: Dr. Anca Vasiliu (Baylor College of Medicine) and Dr. Antonia Morita (Universitas Gadjah Mada, Polish Academy of Science).