The extent to which drug-resistant (DR) Mycobacterium tuberculosis strains cause infection and progression to tuberculosis (TB) disease in comparison to drug-susceptible (DS) strains is unknown. Studies in guinea pigs and in vitro experiments have suggested a reduced fitness of organisms that harbour mutations that confer drug resistance [1, 2]; it was therefore believed that transmitted drug resistance was a rare event. However, more recent work using molecular typing has shown transmission events occurring in the context of DR-TB [3]. Understanding the risk of transmission, infection and progression to disease in the context of DR-TB is important to guide control measures and help predict the evolution and magnitude of the multidrug-resistant (MDR)-TB epidemic. Hence, we performed a systematic review and meta-analysis to assess whether M. tuberculosis transmission and progression to TB disease (risk/rate of M. tuberculosis infection in all contacts, risk/rate of TB disease in all contacts and risk/rate of TB disease in infected contacts) differ between DR- and DS-TB. No evidence that drug-resistant TB results in fewer infections or cases in contacts than drug-susceptible TB http://ow.ly/dgez30f87dr

中文翻译：

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与耐药结核病患者相比，耐药结核病患者的结核分枝杆菌传播：系统评价和荟萃分析

与药物敏感 (DS) 菌株相比，耐药 (DR) 结核分枝杆菌菌株引起感染和进展为结核病 (TB) 疾病的程度尚不清楚。对豚鼠的研究和体外实验表明，具有产生耐药性的突变的生物体的适应性降低 [1, 2]；因此，人们认为传播的耐药性是一种罕见的事件。然而，最近使用分子分型的工作表明，在耐药结核病的背景下发生了传播事件[3]。了解耐药结核病背景下的传播、感染和疾病进展风险对于指导控制措施和帮助预测耐多药（MDR）结核病流行的演变和规模非常重要。因此，我们进行了系统回顾和荟萃分析，以评估 M. DR-TB 和 DS-TB 之间的结核病传播和进展为 TB 病（所有接触者中结核分枝杆菌感染的风险/比率、所有接触者中 TB 病的风险/比率和感染接触者中 TB 病的风险/比率）不同。没有证据表明耐药结核病比药物敏感结核病导致的感染或接触病例更少 http://ow.ly/dgez30f87dr