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We investigate the rates of drug resistance acquisition in a naturalpopulation using molecular epidemiological data from Bolivia. First, we studythe rate of direct acquisition of double resistance from the double sensitivestate within patients and compare it to the rates of evolution to singleresistance. In particular, we address whether or not double resistance canevolve directly from a double sensitive state within a given host. Second, weaim to understand whether the differences in mutation rates to rifampicin andisoniazid resistance translate to the epidemiological scale. Third, we estimatethe proportion of MDR TB cases that are due to the transmission of MDR strainscompared to acquisition of resistance through evolution. To address theseproblems we develop a model of TB transmission in which we track the evolutionof resistance to two drugs and the evolution of VNTR loci. However, theavailable data is incomplete, in that it is recorded only {for a fraction ofthe population and} at a single point in time. The likelihood function inducedby the proposed model is computationally prohibitive to evaluate andaccordingly impractical to work with directly. We therefore approachstatistical inference using approximate Bayesian computation techniques.

Inferences on the acquisition of multidrug resistance in \emph{Mycobacterium tuberculosis} using molecular epidemiological data