Report of Expert Consultations on Rapid Molecular Testing to Detect Drug-Resistant Tuberculosis in the United States

This report presents results from an expert panel convened by CDC to examine the current status of rapid drug-resistance (DR) testing in the United States; to research published evidence and current guidelines; and to provide guidance and make recommendations to CDC for developing a system to provide access to rapid drug-susceptibility testing to all TB control programs in the United States. The panel recommended that CDC establish regional laboratories to provide molecular drug-resistance testing services to state and local TB programs. A phased approach to developing and implementing the testing service was advised. The panel also strongly recommended that CDC immediately establish a service to provide molecular DR testing for TB suspects and patients at high risk of having MDR TB and those deemed high priority by the state or local TB program. The report discusses the background on tests for molecular detection of DR, general considerations and principles for a molecular DR testing service, possible scenarios and scope of testing for such a service, research needs, general recommendations, a communication plan for the report recommendations, and a list of panel members and CDC participants. The appendices include a molecular basis of DR and molecular DR tests, roles and responsibilities in a regional laboratory system for providing for molecular DR testing for TB, and a flow chart of steps in a molecular DR testing service.