Tuberculosis: Staying one step ahead

Cristina Baker, Cepheid’s Senior Director of Medical and Scientific Affairs, discusses how scientific innovation can help bring us closer to an end to tuberculosis

“Chance favors the prepared mind.” Louis Pasteur spoke these words in a French lecture hall in 1854, yet they remain relevant today—especially in the fight against tuberculosis (TB). The disease is unyielding, and drug resistance only raises the stakes. But with each new challenge comes an opportunity for innovation, and Cepheid’s commitment to developing new solutions brings us closer to a future where diseases like TB are a thing of the past.

TB is the world’s leading cause of infectious disease deaths. In 2023, an estimated 10.8 million people fell ill and, tragically, 1.25 million of them lost their lives. Multi-drug resistant (MDR) tuberculosis continues to pose a significant public health threat. Despite this, only 2 in 5 affected individuals with drug-resistant TB accessed treatment in 2023. These statistics are troubling for a disease that is preventable and treatable. Advances in treatment, such as shorter, more tolerable oral regimens, have limited impact if patients are not diagnosed in time, highlighting the critical need for early detection and intervention.

Affecting Change

Access to care is a multi-faceted challenge influenced by stigma, awareness, and the state of healthcare infrastructure. Additionally, many regions face significant issues with testing capacity and diagnostic delay. Traditional methods of smear microscopy followed by culture and drug susceptibility testing are slow and results can take weeks to months, particularly in the case of MDR TB. Waiting that long means people can be lost to follow up, experience negative health outcomes, and continue to transmit infection within their communities. 

Exceptional scientists at Cepheid designed the Xpert® MTB/RIF test to bridge this gap, making advanced molecular testing for TB and rifampicin resistance more accessible to patients. Subsequent innovation with Xpert MTB/RIF Ultra has further reduced turn-around times to under 80 minutes and increased sensitivity, making it easier to accurately diagnose high-risk populations such as immunocompromised individuals. 

Over time, the nature of drug resistance has shifted. Rifampicin was once considered a key marker for broader resistance, but the rise in mono-resistance to isoniazid and the increasing rates of fluoroquinolone resistance changed that. By 2020, Cepheid launched Xpert MTB/XDR, enabling rapid and extended drug resistance profiling. Our advancements aim to stay ahead of this ever-evolving challenge, providing timely and accurate diagnostics to combat the shifting landscape of drug resistance.

Scanning the Horizon

Part of our role in Medical and Scientific Affairs is to continually monitor new drug developments to ensure our diagnostics align with tomorrow’s treatment strategies. By staying ahead of emerging treatments and new diagnostic approaches, we can ensure our tests are best-in-class, supporting healthcare providers and improving patient outcomes.

We are also closely monitoring new research on host-response. Recognizing that each patient reacts uniquely to infection, we aim to understand how diagnostic tests can predict an individual’s disease progression and treatment response. This move towards personalized medicine will ensure patients receive the most targeted treatment and enable providers to stay ahead of the disease.

Cepheid has built its reputation on anticipating what comes next. We began with anthrax detection in response to bioterrorism threats, were one of the first to deliver a molecular test for COVID-19, and continue to push the boundaries of TB diagnostics. In the battle between humans and microbes, complacency is not an option. Staying one step ahead is the key to success. This journey is personal to us, and we are committed to making a difference in the lives of patients and healthcare providers worldwide.