The structural context of mutations in proteins predicts their effect on antibiotic resistance

In Mycobacterium tuberculosis, a prevalent and deadly pathogen, resistance to antibiotics evolves primarily through non-synonymous mutations in proteins. Sequence-based analyses are currently used to understand the genetic basis of antibiotic resistance, either via genotype-phenotype association, or via signals of convergent evolution. These methods focus on primary sequence and often neglect other biological signals such as protein structural information. We hypothesize that integrating the structural context of mutations improves the prediction of effects on function and phenotype. We curate high confidence structural annotations for the M. tuberculosis proteome from 1,371 crystallography