ArticleProceedings of the National Academy of Sciences of the United States of America2009
The epidemiological fitness cost of drug resistance in Mycobacterium tuberculosis.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
66 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Population-level mathematical modeling of antimicrobial resistance: a systematic review.BMC medicine · 2019Pooled it
- Cycling empirical antibiotic therapy in hospitals: meta-analysis and models.PLoS pathogens · 2014Pooled it
- Non-centering for discrete-valued state transition models: an application to ESBL-producingStatistics and computing · 2026Article
- Characteristics of compensatory mutations in rifampicin-resistant tuberculosis and their association with compensated transmission in Ningbo, China.BMC microbiology · 2025Article
- Quantifying the effects of antibiotic resistance and within-host competition on strain fitness in Streptococcus pneumoniae.PLoS biology · 2025Article
- Combating antimicrobial resistance in malaria, HIV and tuberculosis.Nature reviews. Drug discovery · 2024Review
- Discrepancy in the transmissibility of multidrug-resistantEmerging microbes & infections · 2023Article
- Decreased thermal niche breadth as a trade-off of antibiotic resistance.The ISME journal · 2022Article
- Three enigmatic BioH isoenzymes are programmed in the early stage of mycobacterial biotin synthesis, an attractive anti-TB drug target.PLoS pathogens · 2022Article
- Markov genealogy processes.Theoretical population biology · 2022Article
- New Developments and Insights in the Improvement ofCurrent epidemiology reports · 2021Review
- Treating symptomatic infections and the co-evolution of virulence and drug resistance.Peer community journal · 2021Article
- On the probability of strain invasion in endemic settings: Accounting for individual heterogeneity and control in multi-strain dynamics.Journal of theoretical biology · 2020Article
- The Biotin Biosynthetic Pathway in Mycobacterium tuberculosis is a Validated Target for the Development of Antibacterial Agents.Current medicinal chemistry · 2020Review
- Transition bias influences the evolution of antibiotic resistance in Mycobacterium tuberculosis.PLoS biology · 2019Article
- Whole genome sequencing identifies bacterial factors affecting transmission of multidrug-resistant tuberculosis in a high-prevalence setting.Scientific reports · 2019Article
- Treatment as prevention and other interventions to reduce transmission of multidrug-resistant tuberculosis.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2019Article
- Evolutionary epidemiology models to predict the dynamics of antibiotic resistance.Evolutionary applications · 2019Article
- Kernel-density estimation and approximate Bayesian computation for flexible epidemiological model fitting in Python.Epidemics · 2018Article
- Have compensatory mutations facilitated the current epidemic of multidrug-resistant tuberculosis?Emerging microbes & infections · 2018Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The emergence of antibiotic resistance in Mycobacterium tuberculosis has raised the concern that pathogen strains that are virtually untreatable may become widespread. The acquisition of resistance to antibiotics results in a longer duration of infection in a host, but this resistance may come at a cost through a decreased transmission rate. This raises the question of whether the overall fitness of drug-resistant strains is higher than that of sensitive strains--essential information for predicting the spread of the disease. Here, we directly estimate the transmission cost of drug resistance, the rate at which resistance evolves, and the relative fitness of resistant strains. These estimates are made by using explicit models of the transmission and evolution of sensitive and resistant strains of M. tuberculosis, using approximate Bayesian computation, and molecular epidemiology data from Cuba, Estonia, and Venezuela. We find that the transmission cost of drug resistance relative to sensitivity can be as low as 10%, that resistance evolves at rates of approximately 0.0025-0.02 per case per year, and that the overall fitness of resistant strains is comparable with that of sensitive strains. Furthermore, the contribution of transmission to the spread of drug resistance is very high compared with acquired resistance due to treatment failure (up to 99%). Estimating such parameters directly from in vivo data will be critical to understanding and responding to antibiotic resistance. For instance, projections using our estimates suggest that the prevalence of tuberculosis may decline with successful treatment, but the proportion of cases associated with resistance is likely to increase.
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