title: Importance of the genetic diversity within the Mycobacterium tuberculosis complex for the development of novel antibiotics and diagnostic tests of drug resistance.
abstract: Despite being genetically monomorphic, the limited genetic diversity within the Mycobacterium tuberculosis complex (MTBC) has practical consequences for molecular methods for drug susceptibility testing and for the use of current antibiotics and those in clinical trials. It renders some representatives of MTBC intrinsically resistant against one or multiple antibiotics and affects the spectrum and consequences of resistance mutations selected for during treatment. Moreover, neutral or silent changes within genes responsible for drug resistance can cause false-positive results with hybridization-based assays, which have been recently introduced to replace slower phenotypic methods. We discuss the consequences of these findings and propose concrete steps to rigorously assess the genetic diversity of MTBC to support ongoing clinical trials.
authors.affiliation: Department of Medicine, University of Cambridge, Cambridge, UK. cuk21@cam.ac.uk
authors.forename: Claudio U
authors.initials: CU
authors.lastname: Köser
authors.forename: Silke
authors.initials: S
authors.lastname: Feuerriegel
authors.forename: David K
authors.initials: DK
authors.lastname: Summers
authors.forename: John A C
authors.initials: JA
authors.lastname: Archer
authors.forename: Stefan
authors.initials: S
authors.lastname: Niemann
mesh_terms: D000818:Animals; D000995:Antitubercular Agents / Q000494:pharmacology*; D003627:Data Interpretation, Statistical; D024881:Drug Resistance, Bacterial / Q000187:drug effects*; D005838:Genotype; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics*; D014376:Tuberculosis / Q000188:drug therapy
chemical_list: D000995:Antitubercular Agents