Translating basic science insight into public health action for multidrug- and extensively drug-resistant tuberculosis


  • The Authors: Nicholas D. Walter, MD, MS, is an Instructor in Pulmonary Sciences and Critical Care Medicine at the University of Colorado, Denver interested in the adaptation of systems biology tools to epidemiological problems in tuberculosis. Michael Strong, PhD, is an Assistant Professor in the Center for Genes, Environment and Health, at National Jewish Health, and a Faculty member of the computational bioscience program at the University of Colorado, Denver, whose research focuses on computational and genomic approaches to tuberculosis and other respiratory diseases. Robert Belknap, MD, is an Assistant Professor of Medicine in the Division of Infectious Diseases at the University of Colorado and Denver Public Health, and his research interests include epidemiological and clinical trials aimed at improving the treatment and prevention of tuberculosis. Diane J. Ordway, PhD in Infectious and Tropical Diseases, is an Assistant Professor at Colorado State University, Mycobacteria Research Laboratory, Department of Microbiology, Immunology and Pathology, and is one of the leading researchers evaluating the newly emerging multidrug-/extensively drug-resistant tuberculosis strain virulence on host immunity. Charles L. Daley, MD, is a Professor of Medicine and Chief of the Division of Mycobacterial and Respiratory Infections at National Jewish Health, where he focuses on the development of global health policy related to the scale up of multidrug-resistant tuberculosis control. Edward D. Chan, MD is Professor of Medicine at the Denver Veterans Affairs Medical Center, National Jewish Health, and Division of Pulmonary Sciences and Critical Care Medicine at UCD, where his professional interests are in tuberculosis, non-tuberculous mycobacterial lung disease and critical care medicine.


Nicholas D. Walter, Pulmonary Sciences and Critical Care Medicine, University of Colorado Denver, Anschutz Medical Campus, Research 2, Box C272, 9th Floor, 12700 East 19th Avenue, Aurora, CO 80045, USA. Email:


Multidrug (MDR)- and extensively drug-resistant (XDR) tuberculosis (TB) impose a heavy toll of human suffering and social costs. Controlling drug-resistant TB is a complex global public health challenge. Basic science advances including elucidation of the genetic basis of resistance have enabled development of new assays that are transforming the diagnosis of MDR-TB. Molecular epidemiological approaches have provided new insights into the natural history of TB with important implications for drug resistance. In the future, progress in understanding Mycobacterium tuberculosis strain-specific human immune responses, integration of systems biology approaches with traditional epidemiology and insight into the biology of mycobacterial persistence have potential to be translated into new tools for diagnosis and treatment of MDR- and XDR-TB. We review recent basic sciences developments that have contributed or may contribute to improved public health response.