Spontaneous emergence of multiple drug resistance in tuberculosis before and during therapy.
The emergence of drug resistance in M. tuberculosis undermines the efficacy of tuberculosis (TB) treatment in individuals and of TB control programs in populations. Multiple drug resistance is often attributed to sequential functional monotherapy, and standard initial treatment regimens have therefo...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2011-03-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3068161?pdf=render |
| _version_ | 1828424832740491264 |
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| author | Caroline Colijn Ted Cohen Ayalvadi Ganesh Megan Murray |
| author_facet | Caroline Colijn Ted Cohen Ayalvadi Ganesh Megan Murray |
| author_sort | Caroline Colijn |
| collection | DOAJ |
| description | The emergence of drug resistance in M. tuberculosis undermines the efficacy of tuberculosis (TB) treatment in individuals and of TB control programs in populations. Multiple drug resistance is often attributed to sequential functional monotherapy, and standard initial treatment regimens have therefore been designed to include simultaneous use of four different antibiotics. Despite the widespread use of combination therapy, highly resistant M. tb strains have emerged in many settings. Here we use a stochastic birth-death model to estimate the probability of the emergence of multidrug resistance during the growth of a population of initially drug sensitive TB bacilli within an infected host. We find that the probability of the emergence of resistance to the two principal anti-TB drugs before initiation of therapy ranges from 10(-5) to 10(-4); while rare, this is several orders of magnitude higher than previous estimates. This finding suggests that multidrug resistant M. tb may not be an entirely "man-made" phenomenon and may help explain how highly drug resistant forms of TB have independently emerged in many settings. |
| first_indexed | 2024-12-10T16:24:15Z |
| format | Article |
| id | doaj.art-d6cd7cd4ad5d4fe88579357982a6e7ac |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T16:24:15Z |
| publishDate | 2011-03-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-d6cd7cd4ad5d4fe88579357982a6e7ac2022-12-22T01:41:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032011-03-0163e1832710.1371/journal.pone.0018327Spontaneous emergence of multiple drug resistance in tuberculosis before and during therapy.Caroline ColijnTed CohenAyalvadi GaneshMegan MurrayThe emergence of drug resistance in M. tuberculosis undermines the efficacy of tuberculosis (TB) treatment in individuals and of TB control programs in populations. Multiple drug resistance is often attributed to sequential functional monotherapy, and standard initial treatment regimens have therefore been designed to include simultaneous use of four different antibiotics. Despite the widespread use of combination therapy, highly resistant M. tb strains have emerged in many settings. Here we use a stochastic birth-death model to estimate the probability of the emergence of multidrug resistance during the growth of a population of initially drug sensitive TB bacilli within an infected host. We find that the probability of the emergence of resistance to the two principal anti-TB drugs before initiation of therapy ranges from 10(-5) to 10(-4); while rare, this is several orders of magnitude higher than previous estimates. This finding suggests that multidrug resistant M. tb may not be an entirely "man-made" phenomenon and may help explain how highly drug resistant forms of TB have independently emerged in many settings.http://europepmc.org/articles/PMC3068161?pdf=render |
| spellingShingle | Caroline Colijn Ted Cohen Ayalvadi Ganesh Megan Murray Spontaneous emergence of multiple drug resistance in tuberculosis before and during therapy. PLoS ONE |
| title | Spontaneous emergence of multiple drug resistance in tuberculosis before and during therapy. |
| title_full | Spontaneous emergence of multiple drug resistance in tuberculosis before and during therapy. |
| title_fullStr | Spontaneous emergence of multiple drug resistance in tuberculosis before and during therapy. |
| title_full_unstemmed | Spontaneous emergence of multiple drug resistance in tuberculosis before and during therapy. |
| title_short | Spontaneous emergence of multiple drug resistance in tuberculosis before and during therapy. |
| title_sort | spontaneous emergence of multiple drug resistance in tuberculosis before and during therapy |
| url | http://europepmc.org/articles/PMC3068161?pdf=render |
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