Fitness cost of drug resistance in Mycobacterium tuberculosis.
Multidrug-resistant (MDR)--and extensively drug-resistant (XDR)--forms of tuberculosis are growing public health problems. Mathematical models predict that the future of the MDR and XDR tuberculosis epidemics depends in part on the competitive fitness of drug-resistant strains. Here, recent experimental and molecular epidemiological data that illustrate how heterogeneity among drug-resistant strains of Mycobacterium tuberculosis can influence the relative fitness and transmission of this pathogen are reviewed.
Gagneux
S
S
Division of Mycobacterial Research, MRC National Institute for Medical Research, Mill Hill, London, UK. gagneux@nimr.mrc.ac.uk
D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000254:growth & development / Q000502:physiology*; D018088:Tuberculosis, Multidrug-Resistant / Q000382:microbiology* / Q000635:transmission*