0
0
January 31, 2025 — Emerging drug-resistant strains of tuberculosis (TB) are challenging the global fight against one of the world’s deadliest infectious diseases. A new breakthrough method could change the way TB treatment is monitored, offering a faster and more accurate way to assess treatment success.
Researchers from the Marius Nasta Institute (MNI) and the Research Center Borstel, Leibniz Lung Center (FZB) have developed the Molecular Bacterial Load Assay (MBLA), a pioneering test that detects changes in the bacterial load of Mycobacterium tuberculosis within hours, offering the potential for earlier identification of treatment failure.
Published in the Journal of Infection, the study highlights how MBLA could transform the management of TB, particularly in patients infected with drug-resistant strains, which are notoriously difficult to treat. Unlike conventional methods such as sputum smear microscopy, DNA amplification tests, and culture tests, which have limitations in accuracy and time-to-results, MBLA provides rapid results that can guide treatment decisions much sooner.
A New Approach to Monitoring TB Treatment
TB is caused by Mycobacterium tuberculosis and most commonly affects the lungs. Traditional diagnostic methods, while useful, suffer from significant drawbacks. Microscopy, for example, is quick but struggles to differentiate between live and dead bacteria, and DNA amplification tests, such as GeneXpert, can yield false positives after treatment completion. Cultures, though considered the gold standard, take weeks to provide results, delaying necessary interventions.
The MBLA test, developed by medical doctoral student Marit Neumann from the University of Lübeck, represents a major advancement. By measuring the 16S rRNA of M. tuberculosis, a marker of viable bacteria, the MBLA assay can deliver results in just hours. This rapid turnaround is especially important for patients with drug-resistant TB, where the ability to track early treatment response can be critical to success.
Exciting Findings from Clinical Research
The MBLA test was validated in a study conducted at the Research Centre Borstel, where patients with multidrug-resistant (MDR) and extensively drug-resistant (pre-XDR/XDR) TB were monitored. Weekly testing using MBLA, microscopy, GeneXpert, and culture methods provided a comprehensive data set for comparative analysis.
The results were striking: MBLA showed excellent agreement with culture results, particularly in the early stages of treatment. Unlike other diagnostic tests, it was able to detect early changes in bacterial load, providing a more accurate picture of how patients were responding to therapy.
“The MBLA assay offers a culture-free alternative with comparable accuracy to microscopy and superior precision over DNA amplification tests like GeneXpert,” said Neumann. “This method allows for faster adjustments to treatment, which is especially crucial in managing drug-resistant TB.”
A Step Forward in TB Management and Research
The development of MBLA is a significant step forward in TB management. By providing faster results, it could greatly improve patient care by enabling earlier intervention. It also has the potential to accelerate clinical trials for new anti-TB drugs by offering a more efficient method for tracking treatment response.
The findings suggest that MBLA could become a vital tool in the ongoing battle against TB, especially as drug-resistant strains continue to pose a growing threat worldwide.
For more information, see Marit Neumann et al’s paper: The Molecular Bacterial Load Assay Predicts Treatment Responses in Patients with Pre-XDR/XDR-Tuberculosis More Accurately Than GeneXpert Ultra MTB/Rif, published in the Journal of Infection (2024).
Disclaimer: The content of this article is based on findings published in the Journal of Infection. The test discussed, MBLA, is still undergoing clinical validation and may not be widely available for public use. Always consult with healthcare professionals for the latest information on TB treatment.
