General and advanced diagnostic tools to detect Mycobacterium tuberculosis and their drug susceptibility: a review

The global control of tuberculosis remains a great challenge from the standpoint of diagnosis, detection of drug resistance, and treatment, because treatment can only be initiated when infection is detected, and is guided by the results of antimicrobial susceptibility testing. To a large extent, non-molecular, immunological, and other biochemical methods are refinements or modifications of conventional methods, with the primary goal of providing more rapid test results. In contrast, molecular methods use novel technologies to detect the presence of Mycobacterium tuberculosis complex and genes conferring drug resistance. As a group, molecular technologies offer the greatest potential for laboratories in resource-rich countries because they have the highest sensitivity and specificity. In resource-poor settings, continued development of affordable, sensitive, and specific diagnostic tools will be required, where the incidence of disease is highest.