Abstract
Extensive drug resistance is an emerging threat to the control of tuberculosis (TB) worldwide, even in countries with low TB incidence. We report the draft whole-genome sequence of the first reported extensively drug-resistant TB (XDR-TB) strain isolated in Ireland (a low-incidence setting) and describe a number of single-nucleotide variations that correlate with its XDR phenotype.
Highlights
Multidrug resistance (MDR) in tuberculosis (TB) threatens the global management of the disease, which is already a leading cause of infectious mortality worldwide, with an estimated 450,000 MDR-TB cases reported in 2012 [1]
The first Irish XDR-TB strain was isolated in the Irish Mycobacteria Reference Laboratory (IMRL) in 2005 (IEXDR1) [7, 8]
First-line drug susceptibility testing (DST) was completed within 3 weeks, second-line DST within 5 weeks, and the remainder within 14 weeks
Summary
Multidrug resistance (MDR) in tuberculosis (TB) threatens the global management of the disease, which is already a leading cause of infectious mortality worldwide, with an estimated 450,000 MDR-TB cases reported in 2012 [1]. 10% of MDR-TB cases (those resistant to rifampin and isoniazid) are further defined as extensively drug resistant (XDR)-TB, due to their resistance to second-line drugs, fluoroquinolones and injectable aminoglycosides [2]. Long turnaround times (2 to 4 weeks) for phenotypic drug susceptibility testing (DST) (due to the fastidious nature of the organism) can hamper the appropriate treatment of XDR-TB by delaying access to antibiotic susceptibility data [3]. Next-generation sequencing (NGS) can highlight resistance in a timely manner in order to effectively manage treatment and minimize further transmission of resistant strains [4,5,6].
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