title: Whole-genome sequencing of multidrug-resistant Mycobacterium tuberculosis isolates from Myanmar.
abstract: Drug-resistant tuberculosis (TB) is a major health threat in Myanmar. An initial study was conducted to explore the potential utility of whole-genome sequencing (WGS) for the diagnosis and management of drug-resistant TB in Myanmar. Fourteen multidrug-resistant Mycobacterium tuberculosis isolates were sequenced. Known resistance genes for a total of nine antibiotics commonly used in the treatment of drug-susceptible and multidrug-resistant TB (MDR-TB) in Myanmar were interrogated through WGS. All 14 isolates were MDR-TB, consistent with the results of phenotypic drug susceptibility testing (DST), and the Beijing lineage predominated. Based on the results of WGS, 9 of the 14 isolates were potentially resistant to at least one of the drugs used in the standard MDR-TB regimen but for which phenotypic DST is not conducted in Myanmar. This study highlights a need for the introduction of second-line DST as part of routine TB diagnosis in Myanmar as well as new classes of TB drugs to construct effective regimens.
authors.affiliation: Department of Microbiology and Immunology, Otago School of Medical Sciences, University of Otago, Dunedin, New Zealand; Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand. Electronic address: htin.aung@otago.ac.nz.
authors.forename: Htin Lin
authors.initials: HL
authors.lastname: Aung
authors.affiliation: National Health Laboratory, Ministry of Health, Yangon, Myanmar.
authors.forename: Thanda
authors.initials: T
authors.lastname: Tun
authors.affiliation: Department of Medicine, University of Cambridge, Cambridge, UK.
authors.forename: Danesh
authors.initials: D
authors.lastname: Moradigaravand
authors.affiliation: Department of Medicine, University of Cambridge, Cambridge, UK.
authors.forename: Claudio U
authors.initials: CU
authors.lastname: Köser
authors.affiliation: National TB Programme (NTP), Ministry of Health, Naypyidaw, Myanmar.
authors.forename: Wint Wint
authors.initials: WW
authors.lastname: Nyunt
authors.affiliation: National TB Programme (NTP), Ministry of Health, Naypyidaw, Myanmar.
authors.forename: Si Thu
authors.initials: ST
authors.lastname: Aung
authors.affiliation: National TB Programme (NTP), Ministry of Health, Naypyidaw, Myanmar.
authors.forename: Thandar
authors.initials: T
authors.lastname: Lwin
authors.affiliation: Department of Microbiology, University of Medicine 1, Yangon, Myanmar.
authors.forename: Kyi Kyi
authors.initials: KK
authors.lastname: Thinn
authors.affiliation: Centre for International Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: John A
authors.initials: JA
authors.lastname: Crump
authors.affiliation: Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK.
authors.forename: Julian
authors.initials: J
authors.lastname: Parkhill
authors.affiliation: Department of Medicine, University of Cambridge, Cambridge, UK; Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK; London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Peacock
authors.affiliation: Department of Microbiology and Immunology, Otago School of Medical Sciences, University of Otago, Dunedin, New Zealand; Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Cook
authors.affiliation: Centre for International Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Hill
mesh_terms: D000995:Antitubercular Agents; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D016680:Genome, Bacterial; D006801:Humans; D008826:Microbial Sensitivity Tests; D009154:Mutation; D002052:Myanmar; D009169:Mycobacterium tuberculosis / Q000235:genetics*; D018088:Tuberculosis, Multidrug-Resistant / Q000382:microbiology*
chemical_list: D000995:Antitubercular Agents
keywords: Drug-resistant TB; Myanmar; Whole-genome sequencing