Protecting and improving public health in India: Building laboratory, sequencing surveillance and workflow capacity to detect, respond to and prevent drug resistant tuberculosis in India

About 2226 Mycobacterium tuberculosis isolates of tuberculosis patients from India were whole genomes sequenced. Using the current molecular diagnostic technique, the patient samples were categorized as pan-Sensitive, MDR, Pre-XDR, and XDR. In this study, we identified the main drug resistance patterns and TB lineages in India. We compared the molecular test's diagnostic accuracy with WGS data based on genetic mutations found in the corresponding TB isolates. We also developed a comprehensive national catalogue for drug resistance mutations in 14 anti-TB drugs, with confidence grading, and conducted a number of other studies.