PT - JOURNAL ARTICLE AU - Escuyer, Vincent TI - Use of Whole-Genome Sequencing for Detection of Antimicrobial Resistance: <em>Mycobacterium tuberculosis</em>, a Model Organism AID - 10.29074/ascls.2019001784 DP - 2019 Apr 01 TA - American Society for Clinical Laboratory Science PG - 85--92 VI - 32 IP - 2 4099 - http://hwmaint.clsjournal.ascls.org/content/32/2/85.short 4100 - http://hwmaint.clsjournal.ascls.org/content/32/2/85.full SO - Clin Lab Sci2019 Apr 01; 32 AB - Increasing rates of antimicrobial resistance are a public health crisis. The emergence of resistant pathogens is multifactorial but is at least partially due to inappropriate antibiotic utilization and lack of stewardship interventions. Effective stewardship programs require timely antimicrobial resistance testing. This can be challenging for pathogens that grow slowly or not at all in culture. Next-generation sequencing approaches, such as whole-genome sequencing (WGS) of isolate, offer a more rapid alternative for such pathogens. Mycobacterium tuberculosis (TB) is a model organism for WGS to predict susceptibility due to its highly conserved and stable genome, extremely slow growth in culture, and increasing resistance rates to a limited armamentarium of anti-TB drugs. Studies have shown excellent concordance between conventional phenotypic susceptibility testing and use of WGS to predict susceptibility to at least 2 first-line anti-TB agents, rifampin and isoniazid. More data are needed for other agents, including a more comprehensive curated database of mutations paired with phenotypic data, before WGS can completely replace phenotypic testing.