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Linking within-host and between-host evolution of multidrug-resistant Mycobacterium tuberculosis

Project description

Mycobacterium evolution within the host

Mycobacterium tuberculosis (Mtb) has been extensively characterised, but little is known about its evolution within the host. Scientists of the EU-funded ECOEVODRTB project will investigate the hypothesis that in short-sighted evolution there is a trade-off between virulence and transmission. This may be particularly relevant in the context of drug resistance. Therefore, researchers will determine the evolutionary forces and genomic characteristics of multidrug-resistant Mtb in individual patients and how they change over time. They will also develop an experimental approach for providing insight into the evolution of drug resistance with important consequences for tuberculosis treatment and overall public health.

Objective

Mycobacterium tuberculosis (Mtb), the etiologic agent of tuberculosis (TB), is the main cause of human deaths due to infection in general, and to antimicrobial resistance in particular. Little is known on the within-host evolution of Mtb. Theory predicts that in chronic infections like TB, short-sighted evolution operates in the light of a trade-off between virulence and transmission. This trade-off is particularly relevant in the context of drug resistance, given the fitness costs of resistance. However, the role of short-sighted evolution in TB has never been explored empirically. Theory and model systems further predict that phenotypic drug tolerance facilitates the emergence of drug resistance, but the relevance of phenotypic drug tolerance for drug resistance evolution in the clinic has not been established for TB or any other bacterial disease. To address these and related questions, I propose to build on my recent work on the transmission of drug-resistant Mtb with a new focus on the within-patient evolution of drug-resistant Mtb and its link to between-patient evolution during transmission.
Specifically, I shall:
1) Define the genomic characteristics and evolutionary forces shaping multidrug-resistant Mtb populations in individual patients over time and across different body compartments;
2) Compare the genomic and phenotypic properties of multidrug-resistant Mtb populations in individual patients to those circulating within the corresponding patient population;
3) Determine the effect of suboptimal patient treatment and phenotypic drug tolerance on drug resistance evolution in Mtb inside patients.
By combining population genomics of Mtb sampled sequentially and from surgical specimens with experimental evolution and phenotypic characterization of clinical and experimentally evolved strains, this project will generate new insights relevant to both basic science and global public health.

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Keywords

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Programme(s)

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Topic(s)

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Funding Scheme

Funding scheme (or “Type of Action”) inside a programme with common features. It specifies: the scope of what is funded; the reimbursement rate; specific evaluation criteria to qualify for funding; and the use of simplified forms of costs like lump sums.

ERC-ADG - Advanced Grant

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Call for proposal

Procedure for inviting applicants to submit project proposals, with the aim of receiving EU funding.

(opens in new window) ERC-2019-ADG

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Host institution

SCHWEIZERISCHES TROPEN UND PUBLIC HEALTH INSTITUT
Net EU contribution

Net EU financial contribution. The sum of money that the participant receives, deducted by the EU contribution to its linked third party. It considers the distribution of the EU financial contribution between direct beneficiaries of the project and other types of participants, like third-party participants.

€ 1 926 625,00
Address
KREUZSTRASSE 2
4123 ALLSCHWIL
Switzerland

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Region
Schweiz/Suisse/Svizzera Nordwestschweiz Basel-Landschaft
Activity type
Research Organisations
Links
Total cost

The total costs incurred by this organisation to participate in the project, including direct and indirect costs. This amount is a subset of the overall project budget.

€ 1 926 625,00

Beneficiaries (2)

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