title: Antimicrobial Resistance in Mycobacterium tuberculosis: The Odd One Out.
abstract: Antimicrobial resistance (AMR) threats are typically represented by bacteria capable of extensive horizontal gene transfer (HGT). One clear exception is Mycobacterium tuberculosis (Mtb). It is an obligate human pathogen with limited genetic diversity and a low mutation rate which lacks any evidence for HGT. Such features should, in principle, reduce its ability to rapidly evolve AMR. We identify key features in its biology and epidemiology that allow it to overcome its low adaptive potential. We focus in particular on its innate resistance to drugs, its unusual life cycle, including an often extensive latent phase, and its ability to shelter from exposure to antimicrobial drugs within cavities it induces in the lungs.
authors.affiliation: Division of Infectious Disease Control, Norwegian Institute of Public Health, Lovisenberggata 8, Oslo 0456, Norway. Electronic address: v.eldholm@gmail.com.
authors.forename: Vegard
authors.initials: V
authors.lastname: Eldholm
authors.affiliation: Department of Genetics, Evolution and Environment, University College London, Darwin Building, Gower Street, London WC1E 6BT, UK. Electronic address: f.balloux@ucl.ac.uk.
authors.forename: François
authors.initials: F
authors.lastname: Balloux
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D018441:Biofilms; D005075:Biological Evolution; D024881:Drug Resistance, Bacterial / Q000235:genetics* / Q000502:physiology; D022761:Gene Transfer, Horizontal; D014644:Genetic Variation; D006801:Humans; D055985:Latent Tuberculosis; D008018:Life Cycle Stages; D009154:Mutation; D009169:Mycobacterium tuberculosis / Q000235:genetics* / Q000502:physiology; D014376:Tuberculosis / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission
chemical_list: D000900:Anti-Bacterial Agents
keywords: antibiotics; biofilms; evolution; latency; mutation; transmission; tuberculosis