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Genomic analysis of globally diverse Mycobacterium tuberculosis strains provides insights into the emergence and spread of multidrug resistance.


ABSTRACT: Multidrug-resistant tuberculosis (MDR-TB), caused by drug-resistant strains of Mycobacterium tuberculosis, is an increasingly serious problem worldwide. Here we examined a data set of whole-genome sequences from 5,310 M. tuberculosis isolates from five continents. Despite the great diversity of these isolates with respect to geographical point of isolation, genetic background and drug resistance, the patterns for the emergence of drug resistance were conserved globally. We have identified harbinger mutations that often precede multidrug resistance. In particular, the katG mutation encoding p.Ser315Thr, which confers resistance to isoniazid, overwhelmingly arose before mutations that conferred rifampicin resistance across all of the lineages, geographical regions and time periods. Therefore, molecular diagnostics that include markers for rifampicin resistance alone will be insufficient to identify pre-MDR strains. Incorporating knowledge of polymorphisms that occur before the emergence of multidrug resistance, particularly katG p.Ser315Thr, into molecular diagnostics should enable targeted treatment of patients with pre-MDR-TB to prevent further development of MDR-TB.

SUBMITTER: Manson AL 

PROVIDER: S-EPMC5402762 | biostudies-literature | 2017 Mar

REPOSITORIES: biostudies-literature

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Genomic analysis of globally diverse Mycobacterium tuberculosis strains provides insights into the emergence and spread of multidrug resistance.

Manson Abigail L AL   Cohen Keira A KA   Abeel Thomas T   Desjardins Christopher A CA   Armstrong Derek T DT   Barry Clifton E CE   Brand Jeannette J   Chapman Sinéad B SB   Cho Sang-Nae SN   Gabrielian Andrei A   Gomez James J   Jodals Andreea M AM   Joloba Moses M   Jureen Pontus P   Lee Jong Seok JS   Malinga Lesibana L   Maiga Mamoudou M   Nordenberg Dale D   Noroc Ecaterina E   Romancenco Elena E   Salazar Alex A   Ssengooba Willy W   Velayati A A AA   Winglee Kathryn K   Zalutskaya Aksana A   Via Laura E LE   Cassell Gail H GH   Dorman Susan E SE   Ellner Jerrold J   Farnia Parissa P   Galagan James E JE   Rosenthal Alex A   Crudu Valeriu V   Homorodean Daniela D   Hsueh Po-Ren PR   Narayanan Sujatha S   Pym Alexander S AS   Skrahina Alena A   Swaminathan Soumya S   Van der Walt Martie M   Alland David D   Bishai William R WR   Cohen Ted T   Hoffner Sven S   Birren Bruce W BW   Earl Ashlee M AM  

Nature genetics 20170116 3


Multidrug-resistant tuberculosis (MDR-TB), caused by drug-resistant strains of Mycobacterium tuberculosis, is an increasingly serious problem worldwide. Here we examined a data set of whole-genome sequences from 5,310 M. tuberculosis isolates from five continents. Despite the great diversity of these isolates with respect to geographical point of isolation, genetic background and drug resistance, the patterns for the emergence of drug resistance were conserved globally. We have identified harbin  ...[more]

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