Genotypic Diversity and Drug Resistance of Mycobacterium tuberculosis Strains: Summary of the PhD thesis in medical sciences: 313.02 – Microbiology, medical virology

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].[...]