TB Research

Tracking the evolution of an extensively drug-resistant cross-bordercluster, Europe, January 2016 up to August 2025: implications for European surveillance.

Francesca Saluzzo, Chiara Sepulcri, Alma Zinola, Federico Di Marco, Luca Ragazzoni, Marco Rossi, Luigi Codecasa, Daniela Maria Cirillo

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025-11

Abstract

The emergence and spread of an extensively drug-resistant (XDR)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.

MeSH terms

  • Humans
  • Mycobacterium tuberculosis
  • Extensively Drug-Resistant Tuberculosis
  • Europe
  • Antitubercular Agents
  • Whole Genome Sequencing
  • Population Surveillance
  • Male
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Romania
  • Adult
  • Italy