TY - JOUR T1 - Prevalence and genetic basis of first line drug resistance of <strong><em>M. tuberculosis</em></strong> in Ca Mau, Vietnam JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00122-2022 SP - 00122-2022 AU - Jack Callum AU - Phuong T.B. Nguyen AU - Elena Martinez AU - Van-Anh T. Nguyen AU - Frances Garden AU - Nhung V. Nguyen AU - Thu-Anh Nguyen AU - Hoa B. Nguyen AU - Son V. Nguyen AU - Khanh B. Luu AU - Jennifer Ho AU - Nguyen N. Linh AU - Warwick J. Britton AU - Vitali Sintchenko AU - Greg J. Fox AU - Guy B. Marks Y1 - 2022/01/01 UR - http://openres.ersjournals.com/content/early/2022/05/26/23120541.00122-2022.abstract N2 - Background and objective Data on the prevalence of anti-tuberculous drug resistance and its association with genetic mutations in Mycobacterium tuberculosis are limited. Our study explores the genomics of tuberculosis in a high Ca Mau, Vietnam.Methods Patients &gt;15 years in Ca Mau Province, Vietnam, were screened annually for tuberculosis between 2014 and 2017. Isolates underwent drug susceptibility testing (DST) using the breakpoint method. DNA was extracted and whole genome sequencing (WGS) was performed.Results We identified 365 positive sputum cultures for M tuberculosis and processed 237 for DST and 265 for WGS. Resistance to isoniazid was present in 19.8% (95%CI 14.7 to 24.9%), rifampicin in 3.5% (1.1 to 5.7%) and ethambutol in 2.5% (0.9 to 5.4%) of isolates. Relevant mutations in rpoB gene were detected in 3.8% (1.8 to 6.8%). katG, inhA or fabG1 mutations were found in 19.6% (15.0 to 24.9%) with KatG being most common at 12.8% (9.1–17.5%). We found 38.4% of isolates were of Beijing lineage, 49.4% East-African-Indian (EAI) lineage and 8.4% European-American lineage. There were no associations between resistance profiles and clinical features.Conclusion The high burden of isoniazid resistance and the katG mutation highlights the challenges facing Vietnam in its effort to achieve its EndTB goals.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflicts of interest: Warwick Britton advises that support for the present manuscript has been received from National Health &amp; Medical Research Council. Grants or contracts outside the submitted work have been received from Australian Medical Research Future Fund and Perpetual Trustees, Australia. Support for attending meetings and/or travel outside the submitted work received from Bill and Melinda Gates Foundation Collaboration for TB Vaccine Development. Leadership or fiduciary role in other board, society, committee or advocacy group; Board of Trustees, The Leprosy Mission International, disclosure made outside the submitted work.Conflicts of interest: The remaining authors have nothing to disclose. ER -