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Cell. Infect. Microbiol."],"abstract":"<jats:p>\n                    In the past few decades, drug-resistant (DR) strains of\n                    <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                    (\n                    <jats:italic>M.tb<\/jats:italic>\n                    ), the causative agent of tuberculosis (TB), have become increasingly prevalent and pose a threat to worldwide public health. These strains range from multi (MDR) to extensively (XDR) drug-resistant, making them very difficult to treat. Further, the current and future impact of the Coronavirus Disease 2019 (COVID-19) pandemic on the development of DR-TB is still unknown. Although exhaustive studies have been conducted depicting the uniqueness of the\n                    <jats:italic>M.tb<\/jats:italic>\n                    cell envelope, little is known about how its composition changes in relation to drug resistance acquisition. This knowledge is critical to understanding the capacity of DR-\n                    <jats:italic>M.tb<\/jats:italic>\n                    strains to resist anti-TB drugs, and to inform us on the future design of anti-TB drugs to combat these difficult-to-treat strains. In this review, we discuss the complexities of the\n                    <jats:italic>M.tb<\/jats:italic>\n                    cell envelope along with recent studies investigating how\n                    <jats:italic>M.tb<\/jats:italic>\n                    structurally and biochemically changes in relation to drug resistance. Further, we will describe what is currently known about the influence of\n                    <jats:italic>M.tb<\/jats:italic>\n                    drug resistance on infection outcomes, focusing on its impact on fitness, persister-bacteria, and subclinical TB.\n                  <\/jats:p>","DOI":"10.3389\/fcimb.2023.1274175","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T07:35:59Z","timestamp":1698651359000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":32,"title":["Drug-resistant strains of Mycobacterium tuberculosis: cell envelope profiles and interactions with the host"],"prefix":"10.3389","volume":"13","author":[{"given":"Alyssa","family":"Schami","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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