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Seeking the Source of Bacterial Drug Resistance

A targeted deep sequencing assay identifies multidrug-resistant tuberculosis strains responsible for silent outbreaks.

Tuberculosis (TB) is often thought of as a disease of the past. Yet, this potentially lethal medical affliction, once known as “consumption,” remains one of the top 10 causes of death worldwide. According to the World Health Organization (WHO), 10 million people were diagnosed with TB in 2017 and 1. 6 million perished from the disease.1 Its current predominance stems in part from the bacterium’s ability to evolve, even when faced with a six-month treatment regimen of four specific antimicrobial drugs. Such treatment has been used for decades and, over time, many TB strains have developed resistance even to once effective first-line drugs such as isoniazid and rifampicin. In 2017, more than half a million new TB cases were resistant to rifampicin or to both isoniazid and rifampicin, representing multidrug resistance (MDR), and making the disease that much harder to treat and much more likely to spread.2 Early detection of TB outbreaks and effective identification of new MDR-TB strains have become essential in combatting the disease.

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