Abstract:
Tuberculosis (TB) is one of the largest public health challenges
globally. In 2022, the World Health Organization estimated 10.6 million new
cases and 1.3 million deaths due to TB [1]. Currently, one of the most
significant obstacles in reducing TB's impact on public health is the rise of
multidrug-resistant strains of Mycobacterium tuberculosis (MDR strains)
that are resistant to both isoniazid and rifampicin [2]. The incidence of MDRTB
cases is particularly alarming in Eastern European countries, where MDR
rates among newly diagnosed TB patients exceed 30%, and among
retreatment cases, exceed 50% [3]. Disruption of drug supply, inadequate
implementation of treatment regimens in previous decades, alongside poor
infectious control and delayed diagnosis, have facilitated the selection and
sustained transmission of drug-resistant strains, perpetuating the MDR-TB
endemic in this region [4–6]. Moreover, the genetic adaptability and diversity
of Mycobacterium tuberculosis complex strains may directly influence the
perpetuation and spread of drug resistance. Genetic features such as
compensatory mutations and homoplastic mutations could provide
advantages to drug-resistant strains of the M. tuberculosis complex [7].[...]
