ArticleThe Journal of infectious diseases2026
Accuracy of the Phenotypic 1G Test to Detect Mycobacterium tuberculosis and Drug Resistance From Sputa in the US-Mexico Border.
Article in The Journal of infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWith >10 million new tuberculosis (TB) cases per year, a limitation to TB control is the lack of simple and accurate tests for diagnosis and drug susceptibility testing (DST) in endemic regions. We evaluated the accuracy of the first-generation, low-complexity phenotypic TB test (1G test), designed for simultaneous Mycobacterium tuberculosis (Mtb) detection and resistance to isoniazid, rifampicin, and moxifloxacin, suitable for resource-limited settings.
methodsA cross-sectional study was conducted with sputa from 426 possible pulmonary TB cases from 2 small Mexican cities bordering Texas. The 1G test was compared against phenotypic TB detection tests in the region, specifically acid-fast bacilli smear microscopy and Mycobacteria Growth Indicator Tube (MGIT) culture, as well as MGIT-DST for resistance to isoniazid, rifampicin, and moxifloxacin.
resultsThe 1G test demonstrated ≥98% sensitivity for Mtb detection; 100% sensitivity and 91% (rifampicin), 94% (isoniazid), and 97% (moxifloxacin) specificity for DST; and less contamination than the MGIT (3.5% vs 8.1%, P < .05). The 1G test time to detection of Mtb and simultaneous DST was 17 days, while the MGIT-DST required 2 steps: 7 days for Mtb detection plus 14 more days for DST (21 days total). Our study site drug-resistant TB prevalence was 14% when testing all consecutively enrolled participants vs 6% by passive reporting.
conclusionsThe 1G test is a low-complexity phenotypic TB diagnostic method that is a practical replacement to current culture-based tests. Future studies are warranted to evaluate implementation of the 1G test in decentralized clinics that lack molecular tools, resources, and expertise.
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