Whole-genome sequencing analysis to identify antimicrobial resistance regions and virulence factors in Mycobacterium tuberculosis isolates from the Amhara Region, Ethiopia

Tuberculosis, a major global health issue, is characterized by drug-resistant TB, particularly multidrug-resistant TB. In Ethiopia, a high TB-burden country, this study aimed to identify antimicrobial resistance regions and virulence factors in M. tuberculosis isolates using in silico whole-genome sequence analysis. The study identified the most prevalent TB-lineage in the Amhara region as L4 (58.53%), followed by L3 (34.15%), and L1 (4.88%). Drug resistance analysis revealed that 38 isolates (92.7%) were multidrug-resistant, with lineage 4 (59%) and its sub-lineage 4.2.2 showing the highest resistance. The study identified 67 virulence genes, with 63 occurring in all isolates. The high prevalence of MDR-TB and detection of resistance to both first- and second-line drugs highlight the urgent need for enhanced TB control measures in the Amhara region.