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The ecology and evolution of multidrug-resistant Mycobacterium tuberculosis

Multidrug-resistant tuberculosis (TB) causes one third of all human deaths attributable to antimicrobial resistance (AMR). While the main molecular mechanisms of resistance to the maim TB drugs have been studied extensively, little is known on the consequences of AMR on the transmission of TB. AMR is often associated with a reduction in pathogen fitness, which, however, can be mitigated by compensatory mechanisms. I will present the relevance of these concepts for understanding the biology and epidemiology of multidrug-resistant TB as well as the molecular mechanisms involved.