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Peer reviewedOpen accessTuberculosisMultidrug-resistant tuberculosis

The risk of global epidemic replacement with drug-resistant Mycobacterium tuberculosis strains

International Journal of Infectious Diseases·

Emma S. McBryde, Michael T. Meehan, Tan N. Doan, Romain Ragonnet, Ben J. Marais, Vanina Guernier, James M. Trauer

DOI
10.1016/j.ijid.2017.01.031
PMID
28163165
PMCID
OpenAlex
W2585094719
Study type
Mathematical modelling
Publisher
Elsevier BV
Article type
journal-article
Integrity
current

Why this research matters now

The article is relevant to TB control planning because it examines when resistant TB might become dominant and which transmission and treatment-related factors may matter in that scenario. It is mainly a strategic and theoretical contribution rather than an empirical report.

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Structured evidence summary

Research question

The paper asks under what conditions multidrug-resistant tuberculosis could become more common than drug-susceptible tuberculosis, and how transmissibility and control factors might affect that transition.

Study design

A mathematical modelling study. The authors combined evidence from genomics, pharmacokinetics, and epidemiology into a two-strain TB model.

Population and setting

No specific patient cohort, country, or outbreak setting is described in the supplied record. The analysis is framed at the level of tuberculosis strains in a generic control context.

Main findings

In the model, the chance that multidrug-resistant TB would overtake drug-susceptible TB depended strongly on the resistant strain's relative transmissibility. The model suggested that strain replacement could still occur even if transmissibility was somewhat lower than that of the susceptible strain, and that such replacement might take decades or longer. It also separated early resistance amplification from later person-to-person spread.

Public-health relevance

The article is relevant to TB control planning because it examines when resistant TB might become dominant and which transmission and treatment-related factors may matter in that scenario. It is mainly a strategic and theoretical contribution rather than an empirical report.

Important limitations

The supplied evidence is limited to the abstract and bibliographic metadata. The study is model-based, so interpretation depends on assumptions and parameter choices that cannot be fully evaluated without the full paper.

GIDS interpretation

This article is discoverable as a modelling paper about the potential spread and dominance of resistant TB. The supplied abstract does not describe a live surveillance signal or confirm that such replacement has been observed.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 7 auditable classifier relationships to diseases, places, topics, and study design.

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