Whole genome sequencing of two mTB clinical isolates from Odisha.
Background: Tuberculosis remains a significant public health challenge, with Mycobacterium tuberculosis exhibiting variable pathogenicity and drug susceptibility across different geographic regions. Whole genome sequencing provides a powerful tool for understanding strain diversity, antimicrobial resistance, and evolutionary lineage. This study aims to characterize the genomic profile of two clinical mTB isolates from Odisha, India, linking genomic findings with patient metadata and phenotypic drug susceptibility. Methods: Two mTB clinical isolates obtained from two different patients presenting with severe TB manifestations. The first patient 77 year old male exhibited disseminated TB with severe peripheral neuropathy, bedsores, and generalized weakness, with MRI and HRCT suggesting myeloma, osteoporosis, and sarcoidosis. The second patient 26 year old female had an iliacus muscle abscess, requiring CT guided pigtail drainage. WGS was performed to determine lineage, genetic mutations, and drug resistance profiles. Lineage classification and antimicrobial susceptibility predictions were inferred from genomic data. Results: Both isolates were classified under Mycobacteriaceae lineage 1. Comprehensive resistance profiling from WGS data revealed that both isolates were susceptible to all tested first-line anti TB drugs. No major drug resistance conferring mutations were detected.