ArticleFrontiers in microbiology2026
Bedaquiline resistance-associated genetic mutations and minimum inhibitory concentrations in drug-resistant tuberculosis clinical isolates from Limpopo province, South Africa.
Article in Frontiers in microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Bedaquiline (BDQ) resistance is a significant threat to tuberculosis (TB) control efforts, particularly in areas with a high burden of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis, such as South Africa. Determining the minimum inhibitory concentration (MIC) of BDQ and identifying the associated resistance-conferring mutations are critical for understanding resistance patterns and guiding therapeutic decisions. This study investigated BDQ resistance in Method: This study is a cross-sectional study including 147 drug-resistant (DR-TB) isolates obtained from the Polokwane laboratory, Limpopo province, South Africa. The study used phenotypic MIC drug susceptibility testing and whole-genome sequencing (WGS) to investigate BDQ susceptibility patterns. MIC determination and genetic analysis were performed on all isolates with an MIC of >1 μg/mL and a subset of those with an MIC of <1 μg/mL as a control for sequencing. Results: Of the 147 DR-TB isolates included, 128 (87.1%) had an MIC of ≤1 μg/mL (susceptible), while 19 (12.9%) had an MIC of >1 μg/mL (resistant). Whole-genome sequencing revealed that mutations in Conclusion: In this study, BDQ resistance was primarily driven by Rv0678 mutations. As BDQ is one of the few potent drugs available for treating DR-TB, there is a critical need for early detection and continuous surveillance to prevent the spread of resistance.
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