Tracking the evolution of an extensively drug-resistant cross-border Mycobacterium tuberculosis cluster, Europe, January 2016 up to August 2025: implications for European surveillance
The emergence and spread of an extensively drug-resistant (XDR) <i>Mycobacterium tuberculosis</i> 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.
Authors
- Chiara Sepulcri (ORCID: https://orcid.org/0000-0003-1761-436X)
- Federico Di Marco (ORCID: https://orcid.org/0000-0003-0376-1342)
- Luca Ragazzoni (ORCID: https://orcid.org/0000-0002-2528-4375)
- Francesca Saluzzo (ORCID: https://orcid.org/0000-0001-6705-1716)
- Luigi Ruffo Codecasa (ORCID: https://orcid.org/0000-0001-6825-2050)
- Marco Rossi (ORCID: https://orcid.org/0000-0003-3996-8097)
- Daniela María Cirillo (ORCID: https://orcid.org/0000-0001-6415-1535)
- Alma Zinola
Institutions
- Università degli Studi del Piemonte Orientale “Amedeo Avogadro” (IT)
- Vita-Salute San Raffaele University (IT)
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele (IT)
- University of Genoa (IT)
Publication Details
- Journal
- Eurosurveillance
- Published
- 2025-11-20
- DOI
- https://doi.org/10.2807/1560-7917.es.2025.30.46.2500838
- Primary Topic
- Tuberculosis Research and Epidemiology
- Type
- article
- Field-Weighted Citation Impact
- 0.00