0
0
A recent study led by the Swiss Tropical and Public Health Institute (Swiss TPH) has uncovered alarming evidence that tuberculosis (TB) strains resistant to newly approved drugs are being transmitted between patients. Published in the New England Journal of Medicine, the study highlights the pressing need for improved surveillance and infection control measures to address the rising threat of antimicrobial resistance (AMR), particularly in multidrug-resistant tuberculosis (MDR-TB).
A Global Health Threat
Tuberculosis remains the world’s most deadly infectious disease, claiming an estimated 1.25 million lives annually. The disease continues to be a major global health concern, with over 10 million cases reported each year. MDR-TB, which is resistant to the most commonly used antibiotics, presents a particularly severe public health challenge. The disease disproportionately impacts regions such as India, Central Asia, and Southern Africa.
In 2022, the World Health Organization (WHO) recommended a new 6-month treatment regimen for MDR-TB patients, called BPaL(M), based on evidence showing improved safety and efficacy. However, this new regimen has already been met with resistance by the bacteria that cause TB, posing a significant challenge to global efforts to combat the disease.
The Study’s Findings
The Swiss TPH-led study sought to understand how Mycobacterium tuberculosis—the bacteria responsible for TB—would react to the widespread rollout of the new BPaL(M) regimen. Researchers analyzed nearly 90,000 TB strains from Georgia and other countries worldwide, identifying 514 drug-resistant strains. Shockingly, 28% of these highly drug-resistant strains were transmitted directly from patient to patient.
“While we had anecdotal evidence of resistance to the new regimen emerging, we were uncertain about the scale of patient-to-patient transmission,” said Galo A. Goig, the study’s lead author. “Although the total number of such cases remains relatively low, the fact that over a quarter of resistant cases are a result of transmission—only two years after the new regimen was introduced—is deeply concerning.”
The Need for Stronger Surveillance and Infection Control
The study underscores the need for enhanced diagnostic tools, infection control measures, and surveillance systems to prevent further spread of these resistant strains. “The development of new TB drugs is a major step forward, but to ensure their effectiveness, we must combine their deployment with robust surveillance and diagnostic frameworks,” explained Chloé Loiseau, co-author of the study.
In light of these findings, experts warn that the emergence of drug-resistant TB strains represents a growing challenge for public health worldwide. “Antimicrobial resistance is one of the most pressing threats to global health today,” said Sébastien Gagneux, senior author of the study. “We must continue to stay ahead in this race between drug development and bacterial resistance to avoid a future where antibiotics are no longer effective.”
Looking Ahead
While new TB drugs are in development, experts caution that M. tuberculosis will continue to evolve ways to evade treatments. The study’s findings highlight the urgent need for global cooperation and investment in tackling AMR and safeguarding the progress made in TB treatment. Without decisive action, the world could face a “post-antibiotic era” for tuberculosis and other infectious diseases, posing significant risks to global health.
The full study, titled Transmission as a Key Driver of Resistance to the New Tuberculosis Drugs, is available in the New England Journal of Medicine (DOI: 10.1056/NEJMc2404644).
