Genetic Analysis of Molecular Mechanisms of Drug Resistance in Mycobacterium tuberculosis Against Four Major First-Line Anti-Tuberculosis Drugs (Isoniazid, Rifampin, Ethambutol, and Pyrazinamide)

Abstract: Tuberculosis (TB) is a highly contagious and devastating disease that claims millions of lives annually. According to the World Health Organization (WHO), approximately 10.8 million people worldwide will be affected by TB in 2023, highlighting that TB remains the deadliest infectious disease globally. It is the second leading cause of death due to infectious disease. Additionally, the emergence of drug-resistant strains has created a significant challenge for the treatment of this disease. Approximately 25% of TB-related deaths are attributed to antimicrobial drug resistance. Various mechanisms contribute to the development of drug resistance in Mycobacterium tuberculosis ; however, this resistance is primarily due to mutations in the target genes of antibiotics, which reduce the efficacy of anti-TB drugs. This study aimed to provide up-to-date and valuable information on the genetic mechanisms of M. tuberculosis resistance to major first-line anti-TB drugs. Understanding these mechanisms can open new avenues for researchers to treat TB and to overcome drug resistance. Keywords: genetic analysis, drug resistance, Mycobacterium tuberculosis , first-line anti-TB drugs