| Literature DB >> 34031604 |
Sebastian M Gygli1,2, Chloé Loiseau1,2, Levan Jugheli1,2,3, Natia Adamia3, Andrej Trauner1,2, Miriam Reinhard1,2, Amanda Ross1,2, Sonia Borrell1,2, Rusudan Aspindzelashvili3, Nino Maghradze1,2,3, Klaus Reither1,2, Christian Beisel4, Nestani Tukvadze1,2,3, Zaza Avaliani3, Sebastien Gagneux5,6.
Abstract
Multidrug-resistant tuberculosis (MDR-TB) accounts for one third of the annual deaths due to antimicrobial resistance1. Drug resistance-conferring mutations frequently cause fitness costs in bacteria2-5. Experimental work indicates that these drug resistance-related fitness costs might be mitigated by compensatory mutations6-10. However, the clinical relevance of compensatory evolution remains poorly understood. Here we show that, in the country of Georgia, during a 6-year nationwide study, 63% of MDR-TB was due to patient-to-patient transmission. Compensatory mutations and patient incarceration were independently associated with transmission. Furthermore, compensatory mutations were overrepresented among isolates from incarcerated individuals that also frequently spilled over into the non-incarcerated population. As a result, up to 31% of MDR-TB in Georgia was directly or indirectly linked to prisons. We conclude that prisons fuel the epidemic of MDR-TB in Georgia by acting as ecological drivers of fitness-compensated strains with high transmission potential.Entities:
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Year: 2021 PMID： 34031604 PMCID： PMC9400913 DOI： 10.1038/s41591-021-01358-x
Source DB: PubMed Journal: Nat Med ISSN： 1078-8956 Impact factor: 87.241