Multidrug-resistant (MDR)/extensively drug-resistant (XDR) tuberculosis (TB) is a significant threat to global TB control [1]. In most cases, treatment of MDR/XDR TB is not standardized, and clinicians have adopted a variety of treatment strategies. These strategies include switching to a regimen of new drugs, increasing the dosage of the same drugs, rarely used drugs (which have widespread resistance), etc. Drug resistance is a manmade phenomenon that is driven by treatment strategy (i.e., regimen). These divergent approaches may differentially drive the evolution of bacteria. Some instances of this evolution have already occurred [2]. The community’s focus has been on drug resistance; therefore, the consequence of this divergence is usually by different mechanisms of resistance [2] and [3]. However, the full scope of the consequential microevolution frequently goes unnoticed because it also affects important factors such as fitness and virulence. In this study, we aimed to develop a comprehensive understanding of the consequences of differential TB treatment to build more accurate prognostics for future treatments.
Journal: International journal of mycobacteriology
DOI: 10.1016/j.ijmyco.2016.11.017
Year: 2016