biostudies-literatureUnknown13(1)Dorji T<h4>Background</h4>The proportion of multidrug-resistant tuberculosis (MDR-TB) cases is increasing in Bhutan. We conducted the first retrospective genomic-epidemiological study to provide insights into the population structure, resistance patterns, and recent transmission in Bhutan.<h4>Methods</h4>Whole genome sequencing was performed on randomly selected drug-resistant (DR-TB) and drug-sensitive TB (DS-TB) isolates from Bhutan, collected between 2018 and 2022 at the Microbiological Diagnostic Unit Public Health Laboratory in Melbourne, Australia. Bioinformatic analysis was performed to identify drug-resistance mutations and genomic clustering of cases.<h4>Results</h4>Approximately 40% of DR-TB and 2.5% of DS-TB were sequenced each year. Of the 203 sequences that passed the quality controlOpen forum infectious diseasesofaf802https://www.ebi.ac.uk/biostudies/studies/S-EPMC12853382biostudies-literatureExtensive Endemic Transmission of Multidrug-Resistant &lt;i&gt;Mycobacterium tuberculosis&lt;/i&gt; in Bhutan: A Retrospective Genomic-Epidemiological Study.PMC12853382Lhaden PJamtsho TWirth WDenholm JTSait MAndersson PAdhikari LDorji TBhujel PSherry NLStinear TPWangchuk SHowden BPTshering KHoran KfalseExtensive Endemic Transmission of Multidrug-Resistant &lt;i&gt;Mycobacterium tuberculosis&lt;/i&gt; in Bhutan: A Retrospective Genomic-Epidemiological Study.<h4>Background</h4>The proportion of multidrug-resistant tuberculosis (MDR-TB) cases is increasing in Bhutan. We conducted the first retrospective genomic-epidemiological study to provide insights into the population structure, resistance patterns, and recent transmission in Bhutan.<h4>Methods</h4>Whole genome sequencing was performed on randomly selected drug-resistant (DR-TB) and drug-sensitive TB (DS-TB) isolates from Bhutan, collected between 2018 and 2022 at the Microbiological Diagnostic Unit Public Health Laboratory in Melbourne, Australia. Bioinformatic analysis was performed to identify drug-resistance mutations and genomic clustering of cases.<h4>Results</h4>Approximately 40% of DR-TB and 2.5% of DS-TB were sequenced each year. Of the 203 sequences that passed the quality control2026-01-01T00:00:00Z2026 Jan2026-06-19T03:17:25.687Z2026-06-19T03:07:11.27ZS-EPMC128533824162629910.1093/ofid/ofaf802