MIC-based susceptibility testing is dependable for the drugs that decide a regimen

The edition in brief

A meta-analysis of 14 studies and 1,728 isolates assessed the Sensititre MYCOTB broth microdilution plate against reference drug susceptibility testing for multidrug-resistant and pre-extensively drug-resistant tuberculosis. Sensitivity and specificity were high and consistent for rifampicin and isoniazid, specificity exceeded 0.98 for amikacin, kanamycin and ofloxacin, and performance was moderate for ethambutol, streptomycin, ethionamide and rifabutin. Cycloserine performed poorly, with pooled sensitivity of 0.436 even after sensitivity analysis. A stochastic network model calibrated to 2026 Bundibugyo virus outbreak data in the Democratic Republic of the Congo found that improving case detection and contact tracing alone cut expected mortality by 81.6%; adding reactive ring vaccination with a hypothetical 45%-effective vaccine added 10.5 percentage points, while community vaccination at 80% coverage reduced mortality by 86.6% at a cost of up to 111 doses per death averted. A systematic review and global survey covering 1,395,222 HIV-1 samples from 154 countries found subtype C responsible for 48.7% of infections worldwide in 2020-24, with distributions regionally distinct and broadly stable since 2000. A meta-analysis of four comparative studies and 209 patients found no evidence that adjunctive corticosteroids improve outcome in herpes simplex virus encephalitis, with all randomised estimates imprecise and compatible with benefit or harm.