Abstract:
Background: Kazakhstan has a high burden of multidrug-resistant tuberculosis in the
Central Asian region. This study aimed to perform genomic characterization of Mycobacterium tuberculosis strains obtained from Kazakhstani patients with pre-extensively drug-resistant tuberculosis
diagnosed in Kazakhstan. Methods: Whole-genome sequencing was performed on 10 pre-extensively
drug-resistant M. tuberculosis strains from different regions of Kazakhstan. All strains had highconfidence resistance mutations according to the resistance grading system previously established by
the World Health Organization. The genome analysis was performed using TB-Profiler, Mykrobe,
CASTB, and ResFinder. Results: Valuable information for understanding the genetic diversity of
tuberculosis in Kazakhstan can also be obtained from whole-genome sequencing. The results from the
Phenotypic Drug Susceptibility Testing (DST) of bacterial strains were found to be consistent with the
drug resistance information obtained from genomic data that characterized all isolates as pre-XDR.
This information can help in developing targeted prevention and control strategies based on the
local epidemiology of tuberculosis. Furthermore, the data obtained from whole-genome sequencing
can help in tracing the transmission pathways of tuberculosis and facilitating early detection of
outbreaks. Conclusions: The results from whole-genome sequencing of tuberculosis clinical samples
in Kazakhstan provide important insights into the drug resistance patterns and genetic diversity of
tuberculosis in the country. These results can contribute to the improvement of tuberculosis control
and management programs in Kazakhstan.
