bMycobacterium tuberculosis isolates of the Manila sublineage are genetically homogeneous. In this study, we used whole-genome sequencing (WGS) to type a collection of 36 M. tuberculosis isolates of the Manila family. WGS enabled the subtyping of these 36 isolates into at least 10 distinct clusters. Our results indicate that WGS is a powerful approach to determining the relatedness of Manila family M. tuberculosis isolates.M olecular typing techniques help identify linked tuberculosis (TB) cases and provide information that can be used to implement control measures to prevent further TB transmission. Current genotyping techniques, such as mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) typing and spoligotyping, are easy to execute, fast, and, in general, very useful typing methods (1-4). However, for some M. tuberculosis sublineages or families, even 24-locus MIRU-VNTR (MIRU24) typing and spoligotyping combined result in high clustering rates of isolates from otherwise unrelated cases.One of these sublineages is the Manila family, which has been shown to have very low genetic variability, resulting in large genotyping clusters (4, 5). Isolates from this family are found throughout the Pacific basin, including the Philippines, as well as areas of Asia and the western United States (4, 5). In Ontario, Canada, the Manila family is one of the most commonly observed genotypes, representing 13% of all culture-positive cases diagnosed in Public Health Ontario laboratories.The Manila family is a large clonal group for which classical genotyping techniques such as MIRU24 typing and spoligotyping provide low-resolution power (4, 5). Although IS6110 restriction fragment length polymorphism (RFLP) can relatively improve the discrimination power, it has also proven to be of low informative value, as the majority of isolates share the same pattern (4). In a recent study, Frink and colleagues developed a deletion-based subtyping assay to further parse out members of the Manila family. Deletion-based subtyping proved to decrease the clustering rate compared to that of MIRU24 typing and spoligotyping alone, and when used in combination with these two methods, the level of discrimination was even higher (5). Although relatively simple, this method requires the combination of several genotyping techniques in order to obtain meaningful results. Given the inability of currently used genotyping techniques to discriminate between unrelated isolates of the Manila family, it is difficult to draw meaningful conclusions during contact investigations for TB cases due to these isolates.Several reports have shown that whole-genome sequencing (WGS) permits a much finer resolution than current genotyping techniques (6-9). WGS may also be used to identify potential genomic markers such as single-nucleotide polymorphisms (SNPs) that can be incorporated into a subtyping schema (10, 11).The main goal of this study was to evaluate the utility of WGS and phylogenetic analysis to improve the genotyping of the Mani...