Testing of the susceptibility of Mycobacterium tuberculosis to pyrazinamide

Abstract:

Pyrazinamide (PZA) is an indispensable first-line drug for the treatment of tuberculosis. It plays a key role in shortening the course of the treatment from 9–12 months to 6 months. The antibiotics rifampicin (R), isoniazid (H), ethambutol (E), and PZA (Z) form the core control regimen for the drug-sensitive Mycobacterium tuberculosis. However, PZA resistance has led to treatment failure in many patients with the emergence of MDR-TB in recent years. Therefore, it is particularly important for reducing PZA resistance to carry out the susceptibility test. Nevertheless, the test is challenging and often unreliable, as the drug is active only at pH 5.5 which affects the in vitro growth of M. tuberculosis, and thus causes both false-susceptible and false-resistant results. In this review, we summarized the research on susceptibility testing of PZA, hoping to provide a reference for the effective diagnosis and treatment of tuberculosis.