Mechanisms of drug resistance in Mycobacterium tuberculosis

Y. Zhang, W. W. Yew

Research output: Contribution to journalReview articlepeer-review

350 Scopus citations


The increasing emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) in the era of human immunodefi ciency virus (HIV) infection presents a major threat to effective control of TB. Drug resistance in Mycobacterium tuberculosis arises from spontaneous chromosomal mutations at low frequency. Clinical drug-resistant TB largely occurs as a result of man-made selection during disease treatment of these genetic alterations through erratic drug supply, suboptimal physician prescription and poor patient adherence. Molecular mechanisms of drug resistance have been elucidated for the major fi rst-and second-line drugs rifampicin, isoniazid, pyrazinamide, ethambutol, the aminoglycosides and the fl uoroquinolones. The relationship between drug resistance in M. tuberculosis strains and their virulence/transmissibility needs to be further investigated. Understanding the mechanisms of drug resistance in M. tuberculosis would enable the development of rapid molecular diagnostic tools and furnish possible insights into new drug development for the treatment of TB.

Original languageEnglish (US)
Pages (from-to)1320-1330
Number of pages11
JournalInternational Journal of Tuberculosis and Lung Disease
Issue number11
StatePublished - Nov 2009
Externally publishedYes


  • Drug resistance
  • Mechanisms
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases


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