title: A microbiological revolution meets an ancient disease: improving the management of tuberculosis with genomics.
abstract: Tuberculosis (TB) is an ancient disease with an enormous global impact. Despite declining global incidence, the diagnosis, phenotyping, and epidemiological investigation of TB require significant clinical microbiology laboratory resources. Current methods for the detection and characterization of Mycobacterium tuberculosis consist of a series of laboratory tests varying in speed and performance, each of which yields incremental information about the disease. Since the sequencing of the first M. tuberculosis genome in 1998, genomic tools have aided in the diagnosis, treatment, and control of TB. Here we summarize genomics-based methods that are positioned to be introduced in the modern clinical TB laboratory, and we highlight how recent advances in genomics will improve the detection of antibiotic resistance-conferring mutations and the understanding of M. tuberculosis transmission dynamics and epidemiology. We imagine the future TB clinic as one that relies heavily on genomic interrogation of the M. tuberculosis isolate, allowing for more rapid diagnosis of TB and real-time monitoring of outbreak emergence.
authors: The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA Novartis Institutes for Biomedical Research, Cambridge, Massachusetts, USA.
authors: Marta
authors: M
authors: Wlodarska
authors: Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada.
authors: James C
authors: JC
authors: Johnston
authors: British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
authors: Jennifer L
authors: JL
authors: Gardy
authors: British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada Patrick.Tang@bccdc.ca.
authors: Patrick
authors: P
authors: Tang
mesh_terms: D024881:Drug Resistance, Bacterial / Q000235:genetics; D023281:Genomics; D054884:Host-Pathogen Interactions; D006801:Humans; D017720:Molecular Epidemiology; D009154:Mutation / Q000235:genetics; D009169:Mycobacterium tuberculosis / Q000235:genetics*; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission