Prevalence of Mycobacterium tuberculosis resistant to bedaquiline and delamanid in China

作者：Wencong He, Chunfa Liu, Dongxin Liu, Aijing Ma, Yimeng Song, Ping He, Jingjing Bao, Yuanchun Li, Bing Tian Zhao, Jiale Fan, Qian Cheng, Yanlin Zhao · 发表于：Journal of Global Antimicrobial Resistance · 年份：2021 · DOI：10.1016/j.jgar.2021.06.007 · 被引用次数：32 · 研究领域：Tuberculosis Research and Epidemiology、Infectious Diseases and Tuberculosis、Mycobacterium research and diagnosis

OBJECTIVES: The new antituberculous drugs delamanid and bedaquiline form the last line of defence against drug-resistant tuberculosis (TB). Understanding the background prevalence of resistance to new drugs can help predict the lifetime of these drugs' effectiveness and inform regimen design. METHODS: Mycobacterium tuberculosis without prior exposure to novel anti-TB drugs were analysed retrospectively. Drug susceptibility testing for bedaquiline, delamanid, linezolid, clofazimine and widely used first- and second-line anti-TB drugs was performed. All TB isolates with resistance to new or repurposed drugs were subjected to whole-genome sequencing to explore the molecular characteristics of resistance and to perform phylogenetic analysis. RESULTS: Overall, resistance to delamanid, bedaquiline, linezolid and clofazimine was observed in 0.7% (11/1603), 0.4% (6/1603), 0.4% (7/1603) and 0.4% (6/1603) of TB isolates, respectively. Moreover, 1.0% (1/102), 2.9% (3/102), 3.9% (4/102) and 1.0% (1/102) of multidrug-resistant TB (MDR-TB) were resistant to bedaquiline, delamanid, linezolid and clofazimine, respectively. Whereas 22.2% (2/9) of extensively-drug resistant tuberculosis (XDR-TB) isolates were resistant to both delamanid and linezolid, and none was resistant to bedaquiline or clofazimine. Phylogenetic analysis showed that recent transmission occurred in two XDR-TB with additional resistance to delamanid and linezolid. None known gene mutation associated with delamanid resistanc...