Drug-resistant tuberculosis remains a global challenge. In 2024, China recorded approximately 28,000 new cases of rifampicin-resistant tuberculosis, accounting for 7.1% of new cases worldwide. Treatment is difficult, lengthy and costly: while conventional tuberculosis treatment takes 6–8 months, drug-resistant tuberculosis often requires 18–24 months or longer.

A key factor in addressing drug-resistant tuberculosis is drug susceptibility testing.

Drug susceptibility testing (DST) determines in vitro whether Mycobacterium tuberculosis is susceptible to different anti-tuberculosis drugs. Identifying which drugs are effective and which are not enables clinicians to select treatment more precisely.

First-Line DST: Guiding Standard Treatment

First-line anti-tuberculosis drugs are the standard treatment for patients with newly diagnosed pulmonary tuberculosis. First-line drug susceptibility testing provides a core basis for choosing an appropriate treatment regimen, helping to guide standardised therapy while reducing drug toxicity and healthcare costs.

Second-Line DST: Essential Support for Drug-Resistant Patients

Second-line drugs are important treatment options for patients with drug-resistant tuberculosis. Testing susceptibility to these drugs helps exclude ineffective medicines and select an effective combination, reducing the risk of treatment failure and death. It also provides important information for evaluating acquired resistance in patients whose retreatment has failed.

DST Throughout the Treatment Pathway

Drug susceptibility testing should be part of the entire treatment pathway:

At initial diagnosis: DST helps identify primary resistance and determine promptly whether a patient is infected with a resistant strain.

After treatment begins: DST helps detect acquired resistance so that the regimen can be adjusted and ineffective treatment avoided.

Rocgene iFIND®

From Two Months to Results in Hours

Previously, obtaining a drug susceptibility result could take two months. During that wait, patients might receive ineffective medicines while resistant strains continued to spread. The Rocgene iFIND series offers a faster approach.

How should rapid testing tools be used clinically? Different patients require different testing approaches:

Scenario 1: Newly Presenting Patients with Suspected Tuberculosis

Suggested approach: iFIND TBR — tuberculosis identification and rifampicin resistance testing

Key value: Determine resistance to a key first-line drug within 90 minutes

Rifampicin is a cornerstone of standard treatment. Identifying resistance enables clinicians to avoid an ineffective regimen and prevent treatment delays. For newly treated patients, this is an important initial safeguard against inappropriate drug selection.

Scenario 2: Patients with Rifampicin-Resistant Tuberculosis (RR-TB)

Suggested approach: iFIND IFQ — simultaneous isoniazid and fluoroquinolone resistance testing

Key value: Assess resistance to two critical drug groups and help reduce the risk of more extensive resistance

Isoniazid is a key first-line drug, while fluoroquinolones are important second-line agents. IFQ evaluates resistance to both in a single test. For patients with failed retreatment, this also helps assess acquired resistance and preserve subsequent treatment options.

Scenario 3: Patients Undergoing Retreatment or with Severe Disease

Suggested approach: Combine iFIND TBR and iFIND IFQ, either sequentially or simultaneously

Key value: Connect screening, identification, assessment and treatment in a complete workflow, helping clinicians formulate a treatment approach on the same day rather than wait two months for results before changing medicines.

For these challenging cases, TBR can first confirm tuberculosis infection and assess rifampicin resistance, followed by IFQ to evaluate isoniazid and fluoroquinolone resistance. Combining the tests helps clinicians promptly distinguish drug-susceptible tuberculosis, monoresistance, multidrug resistance and pre-extensively drug-resistant tuberculosis involving fluoroquinolone resistance.

Rocgene iFIND®

Core Advantages

Save time: Conventional DST takes 1–2 months, whereas the iFIND series provides results in hours. The time saved represents an important treatment window and an opportunity to interrupt transmission.

Reduce risk: Every additional day of ineffective treatment can allow resistant strains to evolve. Rapidly excluding ineffective drugs helps reduce the risk of progression from multidrug-resistant tuberculosis (MDR-TB) to extensively drug-resistant tuberculosis (XDR-TB).

Reduce the burden: Combining TBR and IFQ helps avoid costly trial-and-error use of second- and third-line drugs, reduce hospital stays, and prevent spending tens of thousands of yuan on ineffective medicines and unnecessary treatment for liver or kidney injury. This can reduce costs for patients and the national health insurance system.

DST is an essential part of precise tuberculosis treatment. It helps make anti-tuberculosis drug selection more targeted.

iFIND

Helping every treatment decision reach the right target.

Towards an end to tuberculosis,

with innovation developed in China.