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Tuberculosis is the world's leading infectious disease killer. We aimed to identify shorter, safer drug regimens for the treatment of tuberculosis. 

Martin J Boeree, Norbert Heinrich, Rob Aarnoutse, Andreas H Diacon, Rodney Dawson, Sunita Rehal, Prof Gibson S Kibiki, Prof Gavin Churchyard, Ian Sanne, Nyanda E Ntinginya, Lilian T Minja, Robert D Hunt, Salome Charalambous, Madeleine Hanekom, Hadija H Semvua, Stellah G Mpagama, Christina Manyama, Bariki Mtafya, Klaus Reither, Prof Robert S Wallis, Amour Venter, Kim Narunsky, Anka Mekota, Sonja Henne, Angela Colbers, Georgette Plemper van Balen, Prof Stephen H Gillespie, Patrick P J Phillips, Prof Michael Hoelscher

Unacceptable levels of Mycobacterium tuberculosis transmission are noted in high burden settings and a renewed focus on reducing person-to-person transmission in these communities is needed. We review recent developments in the understanding of airborne transmission. We outline approaches to measure transmission in populations and trials and describe the Wells-Riley equation, which is used to estimate transmission risk in indoor spaces. 

Dr Tom A Yates, MSc correspondence, Palwasha Y Khan, MBBCh, Gwenan M Knight, PhD, Jonathon G Taylor, PhD, Prof Timothy D McHugh, PhD, Marc Lipman, MD, Richard G White, PhD, Ted Cohen, MD, Prof Frank G Cobelens, PhD, Prof Robin Wood, DSc [Med], Prof David A J Moore, MD, Prof Ibrahim Abubakar, FRCP

The billions of people with latent tuberculosis infection serve as the seedbeds for future cases of active tuberculosis. Virtually all episodes of tuberculosis disease are preceded by a period of asymptomatic Mycobacterium tuberculosis infection; therefore, identifying infected individuals most likely to progress to disease and treating such subclinical infections to prevent future disease provides a crucial opportunity to interrupt tuberculosis transmission and reduce the global burden of tuberculosis disease. Programmes focusing on single strategies rather than comprehensive programmes that deliver an integrated arsenal for tuberculosis control might continue to struggle. 

Molebogeng X Rangaka, Solange C Cavalcante, Ben J Marais, Sok Thim, Neil A Martinson, Soumya Swaminathan, Richard E Chaisson

Accelerating progress in the fight against tuberculosis will require a drastic shift from a strategy focused on control to one focused on elimination. Successful disease elimination campaigns are characterised by locally tailored responses that are informed by appropriate data. To develop such a response to tuberculosis, we suggest a three-step process that includes improved collection and use of existing programmatic data, collection of additional data (eg, geographic information, drug resistance, and risk factors) to inform tailored responses, and targeted collection of novel data (eg, sequencing data, targeted surveys, and contact investigations) to improve understanding of tuberculosis transmission dynamics.

Grant Theron, Helen E Jenkins, Frank Cobelens, Ibrahim Abubakar, Aamir J Khan, Ted Cohen, David W Dowdy

Infections that are resistant to antibiotics are one of the gravest threats to human health with the correct treatment of an infection relying on early detection with accurate diagnostic tests, but current gold-standard methods are slow, requiring days to weeks to culture. Writing in Nature Nanotechnology, Giovanni Longo and colleagues have now shown that low-frequency fluctuations of atomic force microscopy cantilevers can be used to characterize bacteria, rapidly test their sensitivity to antibiotics and identify resistance within minutes. 

McKendry, RA; Natascha K

Tuberculosis (TB) was once a major killer in Europe, but it is unclear how the strains and patterns of infection at 'peak TB' relate to what we see today. Here we describe 14 genome sequences of M. tuberculosis, representing 12 distinct genotypes, obtained from human remains from eighteenth-century Hungary using metagenomics. 

Gemma L. Kay, Martin J. Sergeant, Zhemin Zhou, Jacqueline Z.-M. Chan, Andrew Millard, Joshua Quick, Ildikó Szikossy, Ildikó Pap, Mark Spigelman, Nicholas J. Loman, Mark Achtman, Helen D. Donoghue & Mark J. Pallen

Tuberculosis clinics in London manage more cases a year than those in all other western European capital cities put together. Rates of tuberculosis are now nearly five times higher in the UK than in the USA.2 Lack of progress with tuberculosis control in the UK does not just represent a risk to domestic public health,3 but also an international embarrassment with examples of cases acquired in the UK leading to infections in other low-incidence countries. 

Abubakar, I; Thomas, HL; Morgan, M; Anderson, S; Zenner, D; Cosford, P; (2015)

Antimicrobial resistance invariably follows the introduction of new drugs, and appropriate drug-susceptibility testing assays are needed to detect resistance and tailor treatment regimens that contain new agents.2,3 Given that phenotypic drug-susceptibility testing is slow, technically demanding, and, in some cases, unreliable, future assays are likely to be based on rapid molecular techniques. 

Köser, CU; Javid, B; Liddell, K; Ellington, MJ; Feuerriegel, S; Niemann, S; Brown, NM; Burman, WJ; Abubakar, I; Ismail, NA; Moore, D; Peacock, SJ; Török, ME: (2015)