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The Competitive Cost of Antibiotic Resistance in Mycobacterium tuberculosis

Science  30 Jun 2006:
Vol. 312, Issue 5782, pp. 1944-1946
DOI: 10.1126/science.1124410

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Abstract

Mathematical models predict that the future of the multidrug-resistant tuberculosis epidemic will depend on the fitness cost of drug resistance. We show that in laboratory-derived mutants of Mycobacterium tuberculosis, rifampin resistance is universally associated with a competitive fitness cost and that this cost is determined by the specific resistance mutation and strain genetic background. In contrast, we demonstrate that prolonged patient treatment can result in multidrug-resistant strains with no fitness defect and that strains with low- or no-cost resistance mutations are also the most frequent among clinical isolates.

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