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Printable Handouts
Navigable Slide Index
- Introduction
- Drug-resistant tuberculosis (DR-TB)
- Updated definition of pre and extensively resistant tuberculosis
- The MDR crisis
- New MDR regimens
- Setting up the appropriate break points requires standardisation
- Definitions : WHO, CLSI, EUCAST
- Antimicrobial susceptibility testing (AMST) of mycobacteria: EUCAST
- Relevance of lineages on breakpoints
- Evaluation of CC for pretomanid and cycloserine
- Molecular tests for the diagnosis of DR-TB
- Molecular diagnostics is recommended for the detection of RR
- Should we continue using pyrazinamide (PZA) without sensitivity confirmation?
- NGS
- tNGS for rapid screening of known genes associated with resistance
- New drugs mechanisms of action
- MTB linezolid-resistance associated mutation mechanism
- The challenge of detecting bedaquiline resistance with molecular assays
- Efflux pump mediated bedaquiline resistance/hypersensitivity mechanisms
- Delamanid resistance targets and mutations
- Mechanisms leading to new DR
- tNGS
- Alternative to sputum for diagnosis and screening
- Gaps in diagnostics
- Take home message
- References
- Thank you
Topics Covered
- Drug-resistant tuberculosis
- Drug sensitivity
- Multiple drug resistant TB (MDR-TB)
- MDR crisis
- Lineage breakpoints
- Molecular tests for the diagnosis of DR-TB
- New drugs mechanisms of action
- Mechanisms leading to new DR
- Alternatives to sputum test
Links
Series:
Categories:
Therapeutic Areas:
External Links
- Slides 3-7- Global Tuberculosis Report 2023
- Slide 12-14- WHO consolidated guidelines on tuberculosis: module 3: diagnosis: rapid diagnostics for tuberculosis detection
- Slide 12- Catalogue of mutations in Mycobacterium tuberculosis complex and their association with drug resistance
- Slide 12- WHO launches new guidance on the use of targeted next-generation sequencing tests for the diagnosis of drug-resistant TB and a new sequencing portal
- Slide 12- Technical Report on critical concentrations for drug susceptibility testing of medicines used in the treatment of drug-resistant tuberculosis
- Slide 12- Technical manual for drug susceptibility testing of medicines used in the treatment of tuberculosis
- Slide 15- Catalogue of mutations in Mycobacterium tuberculosis complex and their association with drug resistance
- Slide 15- Guidance for the surveillance of drug resistance in tuberculosis
- Slide 15- The use of next-generation sequencing technologies for the detection of mutations associated with drug resistance in Mycobacterium tuberculosis complex: technical guide
- Slide 17- Clockwork
- Slide 22,31- WHO operational handbook on tuberculosis: module 3: diagnosis: rapid diagnostics for tuberculosis detection
- Slide 26- WHO consolidated guidelines on tuberculosis: module 4: treatment and care
- Slide 28- Consultation on breakpoint changes necessary in conjunction with introducing new definitions of S, I and R in the EUCAST breakpoint Table v 9.0.
- Slide 29- Antimicrobial susceptibility testing of Mycobacteria: EUCAST
- Slide 29- SOP for calibrating surrogate MIC methods for M. tuberculosis against the EUCAST reference MIC method
- Slide 30- BCCM/ITM Mycobacteria Collection
Talk Citation
Cirillo, D. (2025, July 31). Diagnosis of tuberculosis and drug resistant tuberculosis 2 [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved August 1, 2025, from https://doi.org/10.69645/FGZS4274.Export Citation (RIS)
Publication History
- Published on July 31, 2025
Financial Disclosures
- There are no commercial/financial matters to disclose.
Diagnosis of tuberculosis and drug resistant tuberculosis 2
Published on July 31, 2025
32 min
Other Talks in the Series: Periodic Reports: Advances in Clinical Interventions and Research Platforms
Transcript
Please wait while the transcript is being prepared...
0:04
Let's now focus on
drug-resistant tuberculosis.
Drug-resistant tuberculosis
is caused by a strain of
MTB complex resistant to any of
the relevant TB drugs
used in the regimen.
We have mono-resistant phases.
This is the most widespread form
of drug-resistant tuberculosis.
Very common is the
resistance to isoniazid.
Isoniazid-resistant
tuberculosis requires a change
in the therapy strategy.
It needs to be recognized
as early as possible.
We do have mono-resistant
tuberculosis to rifampicin.
In this case,
the same strategy that we
used to detect MDR is used.
Actually, the majority of the
tests that we call a test for
MDR that are
commercially available
only detect rifampicin
resistance.
We assume that being rifampicin
resistant is less common
than isoniazid resistance having
a dose mutation
developing more rarely,
the vast majority
of strains that
become rifampicin resistant have
already accumulated
a mutation that
has made them
isoniazid resistance.
Rifampicin resistance
is a good proxy of MDR.
But we still have a consistent
number of cases that
are isoniazid-sensitive
and rifampicin-resistant.
Anyway, the bottom line is
that rifampicin
resistance and MDR
follow the same
guidelines for treatment.
We define MDR-TB as
TB strains that are resistant
to rifampicin and isoniazid.