Tracking the emergence of extensively drug-resistant Mycobacterium tuberculosis indicates a need for enhanced public health surveillance.
The emergence and spread of an extensively drug-resistant (XDR) Mycobacterium tuberculosis lineage 4.8 cluster in Europe raises public health concerns. First reported in 2020 across Romania, Italy and the United Kingdom, this cluster progressed from multidrug-resistant (MDR) and pre-extensively drug-resistant (pre-XDR) to XDR, including resistance to pretomanid. Evidence of ongoing local transmission is available for Italy, where 10 cases were reported from 2021 to 2025. Strengthened whole genome sequencing-based surveillance is needed to inform timely, coordinated public health responses.
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Saluzzo et al. (2025) studied this question.
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