IJTLD open · 2026
Availability of genotypic and phenotypic drug susceptibility testing for Mycobacterium tuberculosis in WHO European Region.
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Köser C U, Paspaliari D K, Cabibbe A M, Cirillo D M, Yedilbayev A, Ehsani S
Аннотация
BACKGROUND: The WHO European Region has the highest rates of drug-resistant TB globally. Therefore, we studied the availability of genotypic and phenotypic drug susceptibility testing (DST), including targeted next-generation sequencing and whole genome sequencing, for first- and second-line drugs.
METHOD: In 2024, the results of an online survey completed by national and supranational reference laboratories (or equivalent) of 53 countries, territories, and areas of the WHO European Region were reviewed. The availability of DST was analysed using three denominators: 1) the number of countries, territories, and areas for all drugs; 2) the estimated 2024 TB incidence for first-line drugs, including fluoroquinolones; and 3) the estimated 2024 rifampicin-resistant TB incidence for the remaining drugs.
RESULTS: The most important gap in the availability of DST was for pretomanid, the most recently approved anti-TB drug: phenotypic DST was only available for 4% of the estimated incident cases of rifampicin-resistant TB in countries where pretomanid is approved or used programmatically. This contrasted with an availability of phenotypic DST of >98% for bedaquiline, delamanid, and linezolid.
CONCLUSION: The delay between the introduction of novel drugs and the availability of robust DST services should be minimised to avoid intrinsic and selected resistance to novel drugs going unnoticed.
METHOD: In 2024, the results of an online survey completed by national and supranational reference laboratories (or equivalent) of 53 countries, territories, and areas of the WHO European Region were reviewed. The availability of DST was analysed using three denominators: 1) the number of countries, territories, and areas for all drugs; 2) the estimated 2024 TB incidence for first-line drugs, including fluoroquinolones; and 3) the estimated 2024 rifampicin-resistant TB incidence for the remaining drugs.
RESULTS: The most important gap in the availability of DST was for pretomanid, the most recently approved anti-TB drug: phenotypic DST was only available for 4% of the estimated incident cases of rifampicin-resistant TB in countries where pretomanid is approved or used programmatically. This contrasted with an availability of phenotypic DST of >98% for bedaquiline, delamanid, and linezolid.
CONCLUSION: The delay between the introduction of novel drugs and the availability of robust DST services should be minimised to avoid intrinsic and selected resistance to novel drugs going unnoticed.