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The Population Biology of Tuberculosis$
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Christopher Dye

Print publication date: 2015

Print ISBN-13: 9780691154626

Published to Princeton Scholarship Online: October 2017

DOI: 10.23943/princeton/9780691154626.001.0001

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Strains and Drug Resistance

Strains and Drug Resistance

Chapter:
(p.138) Chapter 5 Strains and Drug Resistance
Source:
The Population Biology of Tuberculosis
Author(s):

Christopher Dye

Publisher:
Princeton University Press
DOI:10.23943/princeton/9780691154626.003.0005

This chapter examines the geographical distribution of resistant forms of Mycobacterium tuberculosis and their time trends. Apart from drug resistance, there are plenty of other main questions about M. tuberculosis population genetics. To combat epidemics of drug-resistant TB, it is vital to understand why some resistant strains have greater reproductive fitness than drug-susceptible strains. The chapter first provides an overview of genetic variation in M. tuberculosis before discussing resistance (new and acquired) to first-and second-line drugs. It then considers the link between drug resistance and HIV coinfection, global distribution of drug-resistant TB, relative reproductive fitness, and absolute reproductive fitness. It shows that drug resistance is preventable and reversible, but this must be corroborated and expanded with longer series of data from a wider range of countries, countries with high rates of HIV infection (for example, Botswana and South Africa), and those reporting cases of extensively drug-resistant TB (XDR-TB).

Keywords:   geographical distribution, Mycobacterium tuberculosis, drug resistance, population genetics, resistant strains, reproductive fitness, genetic variation, HIV coinfection, absolute reproductive fitness, tuberculosis

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