Mycobacterium tuberculosis subsp. tuberculosis Genome sequencing. Mycobacterium tuberculosis subsp. tuberculosis

To understand transcontinental spread of MDR M. tuberculosis and the relative contributions of acquired and transmitted drug resistance, we studied WTK, a lineage 2 Mycobacterium tuberculosis strain causing a MDR-TB outbreak within a refugee camp in Thailand and consecutive MDR-TB cases within sympatric communities in California, USA. We used whole genome sequencing to validate and expand findings from infection-control teams in both settings. We mapped 46 genomic sequences from available isolates against the estimated most recent common MTBC ancestor (MRCA) and contextualized with 56 geographically distributed lineage 2 strains.