Abstract
A better understanding of the genomic changes that facilitate the emergence and spread of drug-resistant Mycobacterium tuberculosis strains is currently required. Here, we report the use of the MinION nanopore sequencer (Oxford Nanopore Technologies) to sequence and assemble an extensively drug-resistant (XDR) isolate, which is part of a modern Beijing sub-lineage strain, prevalent in Western Province, Papua New Guinea. Using 238-fold coverage obtained from a single flow-cell, de novo assembly of nanopore reads resulted into one contiguous assembly with 99.92 % assembly accuracy. Incorporation of complementary short read sequences (Illumina) as part of consensus error correction resulted in a 4 404 064 bp genome with 99.98 % assembly accuracy. This assembly had an average nucleotide identity of 99.7 % relative to the reference genome, H37Rv. We assembled nearly all GC-rich repetitive PE/PPE family genes (166/168) and identified variants within these genes. With an estimated genotypic error rate of 5.3 % from MinION data, we demonstrated identification of variants to include the conventional drug resistance mutations, and those that contribute to the resistance phenotype (efflux pumps/transporter) and virulence. Reference-based alignment of the assembly allowed detection of deletions and insertions. MinION sequencing provided a fully annotated assembly of a transmissible XDR strain from an endemic setting and showed its utility to provide further understanding of genomic processes within Mycobacterium tuberculosis.
Highlights
The tuberculosis (TB) incidence rate has shown a slow decline over the last two decades, absolute case numbers continue to rise due to population growth, with an estimated 10.4 million new cases occurring in 2016 [1]
We show the genomic utility of Oxford Nanopore Technologies (ONT) in offering a more comprehensive understanding of genetic mechanisms that contribute to resistance, virulence and transmission
373952 ONT reads passed base calling with N50 read length of 5073bp
Summary
The tuberculosis (TB) incidence rate has shown a slow decline over the last two decades, absolute case numbers continue to rise due to population growth, with an estimated 10.4 million new cases occurring in 2016 [1]. TB control gains are threatened by the growing number of drug resistant strains recorded around the world [2]. An estimated 490,000 incident cases of multi-drug resistant (MDR) TB, which is resistance to at least isoniazid and rifampicin occurred in 2016, accounting for 374,000 deaths among HIV-positive patients [1]. Management of drug resistant tuberculosis places a major financial burden on health systems, which may be overwhelmed in settings with high disease burdens [3]
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