Mycobacterium tuberculosis subculture results in loss of potentially clinically relevant heteroresistance. Mycobacterium tuberculosis

Multidrug-resistant tuberculosis is a major public health dilemma. Heteroresistance, the co-occurrence of multiple M. tuberculosis drug susceptibility profiles within a single specimen, can delay diagnosis and institution of effective treatment. We applied ultra-deep next-generation sequencing to phenotypically drug resistant isolates at two time points in serial culture, and found significant dynamic loss of resistant subpopulations.