The risk of global epidemic replacement with drug-resistant Mycobacterium tuberculosis strains
Objectives: Multidrug-resistant tuberculosis (MDR-TB) is a threat to tuberculosis (TB) control. To guide TB control, it is essential to understand the extent to which and the circumstances in which MDR-TB will replace drug-susceptible TB (DS-TB) as the dominant phenotype. The issue was examined by a...
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| Format: | Article |
| Language: | English |
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Elsevier
2017-03-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971217300346 |
| _version_ | 1818033681537695744 |
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| author | Emma S. McBryde Michael T. Meehan Tan N. Doan Romain Ragonnet Ben J. Marais Vanina Guernier James M. Trauer |
| author_facet | Emma S. McBryde Michael T. Meehan Tan N. Doan Romain Ragonnet Ben J. Marais Vanina Guernier James M. Trauer |
| author_sort | Emma S. McBryde |
| collection | DOAJ |
| description | Objectives: Multidrug-resistant tuberculosis (MDR-TB) is a threat to tuberculosis (TB) control. To guide TB control, it is essential to understand the extent to which and the circumstances in which MDR-TB will replace drug-susceptible TB (DS-TB) as the dominant phenotype. The issue was examined by assessing evidence from genomics, pharmacokinetics, and epidemiology studies. This evidence was then synthesized into a mathematical model.
Methods: This model considers two TB strains, one with and one without an MDR phenotype. It was considered that intrinsic transmissibility may be different between the two strains, as may the control response including the detection, treatment failure, and default rates. The outcomes were explored in terms of the incidence of MDR-TB and time until MDR-TB surpasses DS-TB as the dominant strain.
Results and conclusions: The ability of MDR-TB to dominate DS-TB was highly sensitive to the relative transmissibility of the resistant strain; however, MDR-TB could dominate even when its transmissibility was modestly reduced (to between 50% and 100% as transmissible as the DS-TB strain). This model suggests that it may take decades or more for strain replacement to occur. It was also found that while the amplification of resistance is the early cause of MDR-TB, this will rapidly give way to person-to-person transmission. |
| first_indexed | 2024-12-10T06:27:08Z |
| format | Article |
| id | doaj.art-b66cc899e59b4cb98b733cffd83e10b8 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 1878-3511 |
| language | English |
| last_indexed | 2024-12-10T06:27:08Z |
| publishDate | 2017-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-b66cc899e59b4cb98b733cffd83e10b82022-12-22T01:59:11ZengElsevierInternational Journal of Infectious Diseases1201-97121878-35112017-03-0156C142010.1016/j.ijid.2017.01.031The risk of global epidemic replacement with drug-resistant Mycobacterium tuberculosis strainsEmma S. McBryde0Michael T. Meehan1Tan N. Doan2Romain Ragonnet3Ben J. Marais4Vanina Guernier5James M. Trauer6Australian Institute of Tropical Health and Medicine, James Cook University, 1 James Cook Drive, Townsville, QLD 4811, AustraliaAustralian Institute of Tropical Health and Medicine, James Cook University, 1 James Cook Drive, Townsville, QLD 4811, AustraliaAustralian Institute of Tropical Health and Medicine, James Cook University, 1 James Cook Drive, Townsville, QLD 4811, AustraliaDepartment of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, AustraliaThe Children’s Hospital at Westmead and the Marie Bashir Institute for Infectious Diseases and Biosecurity (MBI), University of Sydney, Sydney, New South Wales, AustraliaAustralian Institute of Tropical Health and Medicine, James Cook University, 1 James Cook Drive, Townsville, QLD 4811, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, AustraliaObjectives: Multidrug-resistant tuberculosis (MDR-TB) is a threat to tuberculosis (TB) control. To guide TB control, it is essential to understand the extent to which and the circumstances in which MDR-TB will replace drug-susceptible TB (DS-TB) as the dominant phenotype. The issue was examined by assessing evidence from genomics, pharmacokinetics, and epidemiology studies. This evidence was then synthesized into a mathematical model. Methods: This model considers two TB strains, one with and one without an MDR phenotype. It was considered that intrinsic transmissibility may be different between the two strains, as may the control response including the detection, treatment failure, and default rates. The outcomes were explored in terms of the incidence of MDR-TB and time until MDR-TB surpasses DS-TB as the dominant strain. Results and conclusions: The ability of MDR-TB to dominate DS-TB was highly sensitive to the relative transmissibility of the resistant strain; however, MDR-TB could dominate even when its transmissibility was modestly reduced (to between 50% and 100% as transmissible as the DS-TB strain). This model suggests that it may take decades or more for strain replacement to occur. It was also found that while the amplification of resistance is the early cause of MDR-TB, this will rapidly give way to person-to-person transmission.http://www.sciencedirect.com/science/article/pii/S1201971217300346Antibiotic resistanceMathematical modellingCommunicable disease controlTuberculosis |
| spellingShingle | Emma S. McBryde Michael T. Meehan Tan N. Doan Romain Ragonnet Ben J. Marais Vanina Guernier James M. Trauer The risk of global epidemic replacement with drug-resistant Mycobacterium tuberculosis strains International Journal of Infectious Diseases Antibiotic resistance Mathematical modelling Communicable disease control Tuberculosis |
| title | The risk of global epidemic replacement with drug-resistant Mycobacterium tuberculosis strains |
| title_full | The risk of global epidemic replacement with drug-resistant Mycobacterium tuberculosis strains |
| title_fullStr | The risk of global epidemic replacement with drug-resistant Mycobacterium tuberculosis strains |
| title_full_unstemmed | The risk of global epidemic replacement with drug-resistant Mycobacterium tuberculosis strains |
| title_short | The risk of global epidemic replacement with drug-resistant Mycobacterium tuberculosis strains |
| title_sort | risk of global epidemic replacement with drug resistant mycobacterium tuberculosis strains |
| topic | Antibiotic resistance Mathematical modelling Communicable disease control Tuberculosis |
| url | http://www.sciencedirect.com/science/article/pii/S1201971217300346 |
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