Abstract

Tuberculosis is the primary infectious disease killer worldwide, with a growing threat from multidrug-resistant cases. Unfortunately, classic growth-based phenotypic drug susceptibility testing (DST) remains difficult, costly, and time consuming, while current rapid molecular testing options are limited by the diversity of antimicrobial-resistant genotypes that can be detected at once. Next-generation sequencing (NGS) offers the opportunity for rapid, comprehensive DST without the time or cost burden of phenotypic tests and can provide useful information for global surveillance. As access to NGS expands, it will be important to ensure that results are communicated clearly, consistent, comparable between laboratories, and associated with clear guidance on clinical interpretation of results. In this viewpoint article, we summarize 2 expert workshops regarding a standardized report format, focusing on relevant variables, terminology, and required minimal elements for clinical and laboratory reports with a proposed standardized template for clinical reporting NGS results for Mycobacterium tuberculosis.

Highlights

  • It is resistant to isoniazid, rifampin, capreomycin, and kanamycin

  • The C1402T mutation is associated with resistance to other injectable drugs including kanamycin and capreomycin

  • This mutation has not been associated with resistance to amikacin in the ReSeqTB database

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Summary

Method WHOLE GENOME SEQUENCING

Pipeline RESEQTB V.3.2C (https://platform.reseqtb.org) Reference H37RV (NC_000962.3). Final Result The sample was positive for Mycobacterium tuberculosis. It is resistant to isoniazid, rifampin, capreomycin, and kanamycin. It has intermediate resistance to ofloxacin and moxifloxacin. Lineage Mycobacterium tuberculosis, lineage 2.2.1 (East-Asian Beijing). Drug Susceptibility Resistance is reported when a resistance-conferring mutation is detected in: embB, gidB, gyrA, gyrB, inhA, katG, mshA, pncA, rpoB, rpsL, rrs, or tlyA.. No mutation detected does not exclude the possibility of resistance. No mutations detected Multi-drug resistance predicted Extensive drug resistance predicted

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