Most resistance-causing mutations in TB have now been identified

Mycobacterium tuberculosis

At the moment, determining whether the strain causing a particular case of TB is resistant to a particular drug is tricky. One common approach, now more than 100 years old, involves culturing microbes from a sputum sample in a Petri dish until they are abundant enough to form a visible plaque. A drug or drugs can then be sprinkled on this plaque, to see if the germs stop proliferating. Butreproduces notoriously slowly in laboratory conditions.

CRyPTIC’s researchers proposed extending PCR testing’s scope by identifying all possible combinations of mutations that confer resistance to any combination of drugs, and also by assessing mutation-related levels of resistance to different doses of a drug. Instead of Petri dishes, participating laboratories used culture plates with 96 wells to grow the bacteria. The wells contained various amounts of 13 tuberculosis drugs. After the drugs had had time to act the plates were photographed.

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