The researchers suggest that this approach “could be integrated into routine diagnostic workflows, phasing out phenotypic drug-susceptibility testing while reporting drug resistance early.”
According to a commentary, this study is an important first step towards routine genomic prediction of antibiotic susceptibility in tuberculosis. Its author calls for a reliable catalogue of resistance mutations if whole-genome sequencing is to be standardised and validated for use in the clinical setting, as is a protocol that can continually be retrained to identify novel resistance-associated mutations when new genomes become available. Although she does not believe genomics can ever completely replace phenotypic-resistance testing, she believes that whole-genome sequencing offers the potential of rapid first-pass phenotyping and, in a world where multidrug-resistant tuberculosis is a growing problem, an opportunity to rationally tailor treatment to individuals.