What is it about?

This study evaluates whether targeted nanopore sequencing can help detect drug-resistant tuberculosis more rapidly and comprehensively in Kyrgyzstan. Drug-resistant tuberculosis remains a major public health challenge because patients need the right treatment as early as possible. Standard drug susceptibility testing is reliable, but it can take time and may not always provide a full picture of resistance to multiple medicines. Targeted nanopore sequencing reads selected tuberculosis genes directly to identify mutations linked to resistance. This approach can provide faster information on whether tuberculosis bacteria are resistant to key medicines, helping clinicians choose more effective treatment regimens. The study compares nanopore targeted sequencing with the current standard-of-care drug susceptibility testing used in Kyrgyzstan. It is based on data from an ongoing study and was presented at the European Respiratory Society Congress 2025 as abstract OA3394. The abstract focuses on the potential role of this sequencing approach in detecting drug-resistant tuberculosis in the Kyrgyz context, where timely diagnosis is essential for patient care and transmission control. This work is important because it supports the modernization of tuberculosis diagnostics in Kyrgyzstan. If implemented successfully, nanopore sequencing could strengthen national laboratory capacity, reduce delays in detecting resistance, and improve the selection of individualized treatment. It may also help the tuberculosis programme monitor resistance patterns, including resistance to newer and repurposed drugs. The next steps should include full validation, assessment of cost-effectiveness, integration into national diagnostic algorithms, staff training, quality assurance, and clear pathways for translating sequencing results into timely treatment decisions.

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Why is it important?

This work is important because drug-resistant tuberculosis requires rapid and accurate diagnosis to ensure that patients receive effective treatment as early as possible. Delays in detecting drug resistance can lead to ineffective therapy, poor treatment outcomes, further development of resistance, and continued transmission of resistant tuberculosis strains. For Kyrgyzstan, this study is particularly relevant because it demonstrates the potential of targeted nanopore sequencing to strengthen national tuberculosis diagnostics. By identifying resistance-associated mutations more rapidly and across multiple drug targets, this approach can support timely clinical decisions, improve individualized treatment, and contribute to better surveillance of drug-resistant tuberculosis. The study also highlights an important step toward modernizing laboratory capacity in the country and integrating genomic technologies into routine public health practice.

Perspectives

The findings of this study open important perspectives for strengthening tuberculosis diagnostics and drug resistance surveillance in Kyrgyzstan. Targeted nanopore sequencing could become a valuable complementary tool to existing diagnostic methods by providing faster and more detailed information on resistance-associated mutations. In the future, this approach may support more timely individualized treatment decisions, improve detection of resistance to first-line and second-line tuberculosis medicines, and contribute to better monitoring of drug-resistant tuberculosis trends at the national level. It may also help strengthen laboratory preparedness for the wider use of genomic technologies in public health. Further work is needed to validate the method under routine programmatic conditions, assess its cost-effectiveness, ensure quality assurance, train laboratory and clinical staff, and define clear pathways for incorporating sequencing results into national diagnostic algorithms and treatment decision-making.

Dr. Bakyt Bolotbekovich Myrzaliev
FHI 360

Read the Original

This page is a summary of: Nanopore targeted sequencing for the detection of drug-resistant tuberculosis compared to standard of care drug susceptibility testing in Kyrgyzstan, September 2025, European Respiratory Society (ERS),
DOI: 10.1183/13993003.congress-2025.oa3394.
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