Oxford University researchers are leading a new worldwide collaboration entitled Comprehensive Resistance Prediction for Tuberculosis: an International Consortium (CRyPTIC) to speed up diagnosis of tuberculosis (TB).
In 2013, 9 million people worldwide developed TB, 1.5 million died from it and an estimated 480,000 new TB cases were resistant to the main antibiotics used to treat the disease (known as multi-drug resistant TB, ‘MDR-TB’). Our reliance on slow, labour-intensive and expensive techniques to determine which antibiotics can kill particular TB infections means under half of drug-resistant cases are detected before treatment. This delay creates uncertainty about the best drugs to prescribe to individual patients and could contribute to the spread of infection. CRyPTIC will attempt to address this problem by using ‘whole-genome sequencing’, a method of reading more than 4 million letters of each TB germ’s genetic code as a faster alternative to identify drug-resistant TB.
This study is a large international alliance spanning five continents and is funded by Bill & Melinda Gates Foundation and Wellcome Trust/MRC Newton Fund. Over 100,000 TB germs will be collected, many of which will be MDR-TB, from across Africa, Asia, Europe and the Americas by teams at more than a dozen centres. Each site will conduct drug-resistance testing on the samples in parallel with whole genome sequencing and the Oxford team will assemble these results into a single open-access database. These data will be compared to a library of other TB bacteria with known drug-resistance to identify genes associated with resistance to certain treatments. Such large numbers are required to find nearly all the changes in the germs’ genetic code that could cause drug-resistance, including very rare ones and we will develop new computer methods to analyse this large amount of genetic data to accurately predict drug-resistance in new TB infections. This will allow future TB cases to be treated with the best drugs faster, increasing the chance of curing individual patients’ infections and will help control its spread, thus contributing to worldwide TB elimination.
Read more about the CRyPTIC Project:
Press Release: Global Team aims for Faster, More Effective TB Diagnosis
Blog: Tuberculosis: Why we’re working to cure TB
Collaborators
Public Health England Regional Centre for Mycobacteriology, Birmingham, UK
San Raffaele Scientific Institute, Milan, Italy
The Foundation of Medical Research, Mumbai, India
P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, India
Chinese Centre for Disease Control and Prevention, Beijing, China
London School of Hygiene and Tropical Medicine (Peru), London, UK
National Institute for Communicable Diseases, Johannesburg, South Africa
Research Centre Borstel, Borstel, Germany
Janssen Therapeutics, New Jersey, USA
Critical Path Institute, Arizona, USA
Atlanta Centre for Disease Control and Prevention, Atlanta, USA
Adolfo Lutz Institute, Sao Paulo, Brazil
Oxford University Clinical Research Unit, Vietnam
Institut Pasteur de Lille
National University Singapore
Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
World Health Organisation, Geneva, Switzerland (Global Tuberculosis Programme)
Imperial College London
University of British Columbia
Mount Sinai, NYC, USA
IML red GmbH, WHO Supranational Reference Laboratory, Gauting, Germany
Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease & Molecular
Medicine, University of Cape Town, South Africa