Biomarkers, Diagnostic, and Therapeutic Approaches for Mycobacterial Diseases

Dear Colleagues,

Tuberculosis (TB) remains a significant global public health challenge, particularly in resource-limited regions. It consistently ranks among the top ten causes of mortality worldwide and is currently the leading cause of death from a single infectious agent, surpassing previous years’ statistics, even during the Covid-19 pandemic. Furthermore, over 100 countries are severely affected by TB and HIV co-infection. In recent decades, there has been a documented increase in the global prevalence and incidence of non-tuberculous mycobacterial (NTM) infections. The prevalence of NTM in adults with non-cystic fibrosis bronchiectasis from 2006 to 2021 is estimated to be approximately 10%, with significant geographical variations.

Combating TB requires a comprehensive strategy that extends beyond traditional control measures. The World Health Organization’s End TB Strategy emphasizes research and development, innovative diagnostics, and effective treatments. Although two new molecules for TB treatment were recently introduced, their adoption has been limited due to high costs. Therapeutic approaches for NTM infections face significant challenges, including drug resistance, lengthy treatment durations requiring strict patient adherence, and the risk of adverse drug reactions. Effective management necessitates continuous monitoring, potential surgical interventions, and comprehensive non-pharmacological support, underscoring the need for a multidisciplinary approach.

Recent research indicates substantial delays in TB diagnosis. Obtaining a mycobacterial culture, the gold standard for diagnosis, can take up to eight weeks, which is impractical for high-burden countries due to the need for advanced laboratory infrastructure. The detection of acid-fast bacilli (AFB), a diagnostic test for pulmonary TB, has limited accuracy. Automated PCR assays offer a faster alternative but are costly and require specialist personnel and equipment. Diagnostic approaches for NTM infections also face several challenges, including non-specific clinical presentations, difficulties in distinguishing true infections from environmental contamination, and limitations in culturing and advanced molecular diagnostics. These issues necessitate comprehensive diagnostic workups, repeated testing, and specialist consultation, highlighting the need for improved diagnostic tools and protocols. Therefore, there is a pressing need to develop new diagnostic tools in microbiology, genetics, immunology, omics, and biomedicine. These tools should facilitate the rapid and precise diagnosis of antimycobacterial diseases, considering comorbidities and autoimmune conditions. Our goal is to improve diagnostic pathways and support timely and effective treatment interventions.

This Special Issue invites contributions that explore biomarkers, diagnostic innovations, and therapeutic approaches for mycobacterial diseases. We seek research articles, reviews, and case studies that present new insights and advancements in these areas.

Dr. Arshad Rizvi
Dr. Yash Gupta
Guest Editors

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• mycobacterium tuberculosis
• nontuberculous mycobacteria
• antimycobacterial
• biomarker
• metabolomics
• drug discovery
• drug resistance
• diagnostic biomarker
• prognostic biomarker
• predictive biomarkers
• surrogate biomarkers
• pharmacodynamic biomarkers