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

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Summary

Introduction

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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