Predominance of the East-Asian Beijing genotype in a Mycobacterium tuberculosis drug-resistant population in Central Malaysia

Objectives: Previous diversity studies on local Mycobacterium tuberculosis (MTB) isolates, with or without antibiotic resistance, showed predominance of Indo-Oceanic East African-Indian (EAI) strains. This study focused specifically on a drug-resistant MTB population from Central Malaysia and aimed to investigate the genotypes and resistance patterns involved. Methods: Whole-genome sequencing was performed on 56 local MTB isolates with known rifampicin resistance or multidrug resistance towards 13 anti-TB agents. Analysis of each genome sequence was performed using the widely recognized online MTB genotyping platforms, TBProfiler and Mykrobe, to determine lineage and genotypic drug resistance profiles. Results: Forty (71.4%) isolates were identified as East-Asian Beijing strains. Phenotypic to genotypic antibiotic resistance patterns differed in 33 isolates (58.9%), with one isolate showing extensive drug-resistance (XDR) previously not detected by conventional drug-susceptibility testing. Conclusion: This drug resistance population study demonstrated predominance of the East-Asian Beijing strains and a newly detected extensively drug-resistant MTB (XDR-TB) isolate in Malaysia. Information regarding the association between lineage and drug-resistant TB in Malaysia is scarce, and more studies are needed to determine the significance of such association, if any, in our local settings. (C) 2022 The Authors. Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy.