TY - JOUR T1 - <em>Mycobacterium tuberculosis</em> transmission from patients with drug-resistant compared to drug-susceptible TB: a systematic review and meta-analysis JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01044-2017 VL - 50 IS - 4 SP - 1701044 AU - Chiori Kodama AU - Berit Lange AU - Ioana D. Olaru AU - Palwasha Khan AU - Marc Lipman AU - James A. Seddon AU - Derek Sloan AU - Louis Grandjean AU - Rashida Abbas Ferrand AU - Katharina Kranzer Y1 - 2017/10/01 UR - http://erj.ersjournals.com/content/50/4/1701044.abstract N2 - 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/dgez30f87drWe would like to acknowledge the valuable administrative support during the conduct of this study by Johannes Camp and Lucy Wong of University Hospital Freiburg. Contributions of authors: K. Kranzer conceived the idea for the systematic review. K. Kranzer, C. Kodama and B. Lange designed the study. K. Kranzer, C. Kodama and B. Lange performed screening and data extraction. C. Kodama and B. Lange assessed risk of bias. B. Lange and K. Kranzer performed the meta-analysis. I. Olaru, P. Khan, M. Lipman, J. Seddon, D. Sloan, L. Grandjean and R. Ferrand contributed to the analysis and manuscript writing. All authors read and approved the final version of the manuscript. ER -