Implementation of Whole Genome Sequencing of Tuberculosis Isolates in a Referral Center in Rome: Six Years' Experience in Characterizing Drug-Resistant TB and Disease Transmission

Overview

Journal Antibiotics (Basel)

Specialty Pharmacology

Date 2024 Feb 23

PMID 38391520

Authors

Angela Cannas

Ornella Butera

Antonio Mazzarelli

Francesco Messina

Antonella Vulcano

Mario Pasquale Parracino

Gina Gualano

Fabrizio Palmieri

Antonino Di Caro

Carla Nisii

Carla Fontana

Enrico Girardi

Affiliations

Soon will be listed here.

Abstract

Over the past years, Tuberculosis (TB) control strategies have been effective in reducing drug-resistant (DR) TB globally; however, a wider implementation of new diagnostic strategies, such as Whole genome sequencing (WGS), would be critical for further improvement. The aim of this study, based on WGS of (MTB) strains isolated in a TB referral center over 6 years, was to evaluate the efficacy of this methodology in improving therapy guidance for clinicians and in improving the understanding of the epidemiology of TB transmission. WGS was performed in addition to pDST on 1001 strains consecutively isolated between January 2016 and December 2021; the results allowed us to improve the quality of data on resistance and to identify possible clusters of transmission. Prediction of rifampicin-resistant (RR) or multi-drug-resistant TB strains (MDR-TB, defined as resistance to at least rifampicin and isoniazid) was obtained for 50 strains (5%). Mutations predictive of an MDR isolate were further characterized, and Ser450Leu and Ser315Thr were found to be the most frequent mutations in and genes, respectively. Discordances between WGS and phenotypic drug susceptibility testing (pDST) were found in few strains, and their impact on clinical decisions and outcome was addressed. The introduction of WGS in our Institute improved our diagnostic routine, allowing accurate patient management, and was a valid instrument for epidemiological investigations and infection control.

Citing Articles

Safety and Effectiveness of BPaL-Based Regimens to Treat Multidrug-Resistant TB: First Experience of an Italian Tuberculosis Referral Hospital.

Gualano G, Musso M, Mencarini P, Mosti S, Cerva C, Vittozzi P Antibiotics (Basel). 2025; 14(1.

PMID: 39858293 PMC: 11762953. DOI: 10.3390/antibiotics14010007.

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