The heterogeneous evolution of multidrug-resistant Mycobacterium tuberculosis.

The heterogeneous evolution of multidrug-resistant Mycobacterium tuberculosis.
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DOI:
10.1016/j.tig.2012.11.005
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发表时间:
2013-03
期刊:
影响因子:
11.4
通讯作者:
Gagneux, Sebastien
Gagneux, Sebastien
中科院分区:
生物学1区
文献类型:
--
作者:
Mueller, Borna;Borrell, Sonia;Rose, Graham;Gagneux, Sebastien

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耐多药结核病(MDR-TB)的最新监测数据报告了有史以来最高的耐药率。随着结核分枝杆菌多药耐药株耐药性的进一步扩大,广泛耐药(XDR)和完全耐药(TDR)结核病开始出现。虽然在很大程度上了解了耐多药结核病传播所涉及的流行病学因素,但对耐多药结核病的细菌驱动因素的洞察只是最近才获得的,这主要是由于对其他生物的新技术和研究。在此,我们综述了细菌因素,如持久性、超突变、耐药与适合度之间的复杂相互关系、补偿进化和上位性等如何影响结核分枝杆菌多药耐药进化的最新研究结果。加强对这些因素的了解将有助于更好地预测耐多药结核病的未来发展轨迹,并有助于开发新的工具和战略来抗击这一日益严重的公共卫生威胁。
Recent surveillance data of multidrug-resistant tuberculosis (MDR-TB) reported the highest rates of resistance ever documented. As further amplification of resistance in MDR strains of Mycobacterium tuberculosis occurs, extensively drug-resistant (XDR) and totally drug resistant (TDR) TB are beginning to emerge. Whilst for the most part, the epidemiological factors involved in the spread of MDR-TB are understood, insights into the bacterial drivers of MDR-TB have been gained only recently, largely owing to novel technologies and research in other organisms. Herein, we review recent findings on how bacterial factors such as persistence, hypermutation, the complex interrelationship between drug resistance and fitness, compensatory evolution, and epistasis affect the evolution of multidrug resistance in M. tuberculosis. Improved knowledge of these factors will help better predict the future trajectory of MDR-TB, and contribute to the development of new tools and strategies to combat this growing public health threat.
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由巨噬细胞诱导的外排机制介导的复制分枝杆菌的药物耐受性。
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