Tuberculosis and Mycobacterial Diseases: Pathophysiology, Drug Resistance, and the Path Toward Elimination

Tuberculosis remains the world’s leading infectious cause of death from a single pathogen, and the global threat of drug-resistant tuberculosis — including multidrug-resistant and extensively drug-resistant forms — presents formidable challenges to elimination targets. This chapter provides a detailed review of Mycobacterium tuberculosis pathogenesis, the immunology of latency and reactivation, and the molecular basis of drug resistance. It surveys advances in diagnostic platforms, evaluates shortened treatment regimens and new drug combinations supported by recent clinical trial data, and discusses the current tuberculosis vaccine development pipeline. The role of host-directed therapies and the intersection of tuberculosis with HIV co-infection and non-communicable diseases are also critically examined.