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Nina M. Billows, Jody E. Phelan, Dong Xia, Yonghong Peng, Taane G. Clark, Yu-Mei Chang (nbillows@rvc.ac.uk)
Antimicrobial Resistance (AMR) is increasingly threatening the effective treatment of infectious diseases across the globe. This is especially true in Mycobacterium tuberculosis; the bacteria responsible for causing the greatest number of deaths than any other single infectious agent worldwide. Understanding the evolution of Mycobacterium tuberculosis genome mutations and their links to AMR can decipher the resistance mechanisms, improve treatment of tuberculosis and advance drug development. Here, we have analysed whole genome sequences of over 34,000 isolates that have shown different degrees of resistance to first- and second-line drugs. Isolates can be classified as pan-susceptible, multidrug-resistant (resistant to first-line drugs rifampicin and isoniazid) and extremely drug-resistant (resistant to one of the second-line injectables such as amikacin, capreomycin and kanamycin and any fluoroquinolone). We present phylogenetic trees to simultaneously observe the structure of the bacterial population and its resistance to the drugs used to treat tuberculosis. By observing the distribution of these phenotypes, we are able to see the increasing impact that AMR is having on tubercu