Under the National Tuberculosis Elimination Programme (NTEP), the concept of 'Universal Drug Susceptibility Testing' (UDST) mandates that ALL TB patients should receive drug susceptibility testing. The primary test currently recommended at the point of diagnosis in India for UDST is:
- A Cartridge-Based Nucleic Acid Amplification Test (CB-NAAT/Xpert MTB/RIF) ✓
- B Liquid culture with BACTEC MGIT
- C Line Probe Assay (LPA) for first-line drugs
- D Solid Löwenstein-Jensen culture with proportion method
Explanation
NTEP's UDST strategy recommends CB-NAAT (Xpert MTB/RIF or TrueNat) as the upfront molecular diagnostic for all presumptive TB patients to simultaneously detect Mycobacterium tuberculosis and rifampicin resistance. This enables simultaneous diagnosis and initial drug resistance detection in under 2 hours at the district level. LPA is used as a reflex test for isoniazid and fluoroquinolone resistance in RIF-resistant cases. Liquid culture is the gold standard but is used for confirmation and extended DST, not as the first-line universal test at point of diagnosis.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.