الفهرس 
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Abstract
This study explored the genetic diversity of Mycobacterium tuberculosis isolates in Egypt by spoligotyping in combination with pncA gene sequencing, spoNC. Firstly, 50 isolates out of 400 isolates positive for Mycobacterium tuberculosis were referred to Central Labs Ministry of health were subjected to the analyses, 21 isolates were found to be multidrug resistant (MDR) and 29 isoletes were sensitive for isonizide(INH) and rifampicine(RIF) after testing by phenotypic drug susceptibility testing (DST) and MGIT. Spoligotyping yielded 45 patterns belonging to 7 families that were previously reported in neighboring countries as Iraq, Syria, Iran and Turky. while 4 isolates were orphans. Application of spoNC on obtained Spoligotype patterns enhance to reduce the clustering rate. Bejing family the predominant (34%)were subdivided by pncA sequence into 3 sensitive DST pncA wild type , 3 MDR-DST isolates showing cys14Arg mutation in pncA, 2 sensitive DST isolates with pncA Gly97Asp mutation, and 3 sensitive DST pncAVal128Gly mutation. The next most common CASI_DELHI family (16%) were subdivided by pncA sequencing into CASI_DELHI (st 381, MDR) including 2 pncA silent mutation ser65ser (tcc>tct) and CASI_DELHI (st26, sensitive) which included 6 pncA (WT) results, LAM6 family(6%) all had PncA Gly97Asp mutation, We concluded that SpoNC providesgood snap shot for MDR surveillance and its country origin, and performing early identification of outbreaks in Egypt