Open AccessHow To Optimally Combine Genotypic and Phenotypic Drug Susceptibility Testing Methods for Pyrazinamide
Author(s) -
Claudio U. Köser,
Daniela María Cirillo,
Paolo Miotto
Publication year - 2020
Publication title -
antimicrobial agents and chemotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.07
H-Index - 259
eISSN - 1070-6283
pISSN - 0066-4804
DOI - 10.1128/aac.01003-20
Subject(s) - pyrazinamide , phenotype , genotype , mycobacterium tuberculosis , genetics , drug resistance , biology , drug , mutation , tuberculosis , computational biology , medicine , pharmacology , gene , pathology
False-susceptible phenotypic drug-susceptibility testing (DST) results for pyrazinamide due to mutations with MICs close to the critical concentration (CC) confound the classification of pncA resistance mutations, leading to an underestimate of the specificity of genotypic DST. This could be minimized by basing treatment decisions on well-understood mutations and by adopting an area of technical uncertainty for phenotypic DST rather than only testing the CC, as is current practice for the Mycobacterium tuberculosis complex.