MIC-based tuberculosis drug susceptibility testing using Sensititre MYCOTB: a diagnostic accuracy meta-analysis.

Daniel Raj D; Mukesh Kumar G; Jitendra Singh; Sabir Ali; Shaina Gaikwad; Tharani Mohankumar; Swathi S; Shashank Purwar; Debasis Biswas; Anand Kumar Maurya; Sanjit Sah; Aroop Mohanty; Rachana Mehta

doi:10.1128/jcm.00813-26

PubMed · 42623427

MIC-based tuberculosis drug susceptibility testing using Sensititre MYCOTB: a diagnostic accuracy meta-analysis.

Daniel Raj D·Mukesh Kumar G·Jitendra Singh·Sabir Ali·Shaina Gaikwad·Tharani Mohankumar·Swathi S·Shashank Purwar·Debasis Biswas·Anand Kumar Maurya·Sanjit Sah·Aroop Mohanty·Rachana Mehta

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Abstract

Accurate drug susceptibility testing (DST) is crucial for designing effective regimens for multidrug-resistant (MDR) and pre-extensively drug-resistant tuberculosis (pre-XDR TB). Sensititre MYCOTB enables simultaneous determination of minimum inhibitory concentrations (MICs) for multiple drugs, but its diagnostic performance varies across studies. This meta-analysis evaluated the diagnostic performance of Sensititre MYCOTB for key MDR and pre-XDR TB drugs. The protocol was registered in PROSPERO (CRD420251230599). PubMed, Cochrane, Google Scholar, Scopus, ONOS, Web of Science, ScienceDirect, and registries were systematically searched for studies published between 2010 and 2025. Studies comparing the Sensititre MYCOTB with reference DST for Mycobacterium tuberculosis complex (MTBC) were included. Bias assessment and pooled diagnostic accuracy estimates were generated. Fourteen studies, including 1,728 isolates, were analyzed. Rifampicin and isoniazid demonstrated high sensitivity (0.976 [95% CI: 0.94-0.99] and 0.977 [95% CI: 0.95-0.99]) and specificity (0.958 [95% CI: 0.84-0.98] and 0.957 [95% CI: 0.83-0.99], respectively) with low heterogeneity. Amikacin, kanamycin, and ofloxacin demonstrate good diagnostic accuracy, with high specificity (>0.98 [95% CI]). Moderate diagnostic accuracy was observed for ethambutol, streptomycin, ethionamide, and rifabutin. Cycloserine, moxifloxacin, and para-aminosalicylic acid showed inconsistent performance despite excellent specificity (>0.97 [95% CI]). Sensitivity analysis partially improved pooled sensitivity for moxifloxacin 0.801 (95% CI: 0.585-0.924) and para-aminosalicylic acid 0.76 (95% CI: 0.518-0.894), whereas cycloserine remained at 0.436 (95% CI: 0.190-0.725), although heterogeneity persisted. Sensititre MYCOTB DST demonstrates high diagnostic accuracy for MDR-TB and pre-XDR-TB drugs, while caution is required with cycloserine, moxifloxacin, and para-aminosalicylic acid. These findings support the integration of MIC-based testing into clinical decision-making.

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Microbial Sensitivity Tests Humans Mycobacterium tuberculosis Antitubercular Agents Sensitivity and Specificity Tuberculosis, Multidrug-Resistant gold standard DST method comparison phenotypic drug susceptibility test sensititre MYCOTB AST plate Journal Article Meta-Analysis Systematic Review Review

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Daniel Raj D, Mukesh Kumar G, Jitendra Singh, Sabir Ali, Shaina Gaikwad, Tharani Mohankumar, Swathi S, Shashank Purwar, Debasis Biswas, Anand Kumar Maurya, Sanjit Sah, Aroop Mohanty, Rachana Mehta. 2026-08-20. MIC-based tuberculosis drug susceptibility testing using Sensititre MYCOTB: a diagnostic accuracy meta-analysis.. https://doi.org/10.1128/jcm.00813-26

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Humans subject Journal Article subject Journal Article; Meta-Analysis; Systematic Review; Review resource Meta-Analysis subject Microbial Sensitivity Tests subject Mycobacterium tuberculosis subject Systematic reviews study

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