Clinical Importance of Whole-genome Sequencing for a Timely Diagnosis and Management of Drug-resistant Tuberculosis (DR-TB): Two Case Reports from Pune City, India

A BSTRACT In recent years, there is an emergence of severe forms of drug-resistant tuberculosis known as multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB). The conventional methods such as culture and drug susceptibility testing often delay diagnosis of drug-resistant TB and lead to deterioration of patient’s health and transmission of TB strains in the community. The cutting-edge technology such as Whole Genome Sequencing (WGS) of TB strains can offer rapid diagnosis of resistant TB at an affordable cost and guide an accurate therapy. Here, we present two case studies of individuals from Pune who had drug-resistant TB. These case studies underscore an urgent need for deploying the WGS. However, we also discussed challenges in implementing WGS especially in a TB high burden country such as India to provide an understanding of ground level needs which can help guide efforts toward effective implementation of WGS.