Global patterns of bedaquiline/snare resistance in drug-resistant tuberculosis

Drug-resistant tuberculosis (MDR-TB) refers to the resistance of Mycobacterium tuberculosis to at least two first-line anti-tuberculosis drugs, isoniazid and rifampicin, and Bedaquiline (Bedaquiline; BDQ) is one of the representatives of new anti-tuberculosis drugs, and the study of its drug resistance is particularly important. The purpose of this study was to summarize the prevalence of bedaquiline resistance in patients with drug-resistant tuberculosis and evaluate its global pattern, thereby providing a scientific basis for future prevention, control and treatment of drug-resistant tuberculosis.

Researchers conducted a retrospective study to carefully analyze the emergence of bedaquiline resistance in individuals receiving treatment for multidrug-resistant tuberculosis. The study used systematic review and meta-analysis methods to screen relevant literature from multiple databases, includingPubMed, Web of Science, and Embase. To ensure the reliability of the results, the research team used sensitivity and subgroup analyzes to identify heterogeneity and compare prevalence across different populations and regions. In addition, the study used the Joanna Briggs Institute checklist to assess the methodological quality of included studies to ensure the scientific validity and accuracy of the analysis results.

In data analysis, the research team usedCochran's Q and I2 statistical methods to assess heterogeneity between studies. Using these methods, the researchers were able to identify sources of variation between different study results, thereby more accurately elucidating the issue of bedaquiline resistance. This review was registered with PROSPERO (registration number CRD42024620791) before the start of the study, which ensures the standardization and transparency of the study.

The study results showed that the average prevalence of bedaquiline resistance was 5.7% (95% CI: 3.6-8.3), of which 5.4% was acquired resistance. This indicates that bedaquiline resistance has become a problem that cannot be ignored in patients with multidrug-resistant tuberculosis. Further analysis showed that high-quality studies reported a prevalence of 5.2%, while moderate-quality studies reported a prevalence of 7.7%. This reflects that methodological differences in the design and conduct of different studies may affect the interpretation of results, emphasizing the importance of high-quality methodological design when conducting such studies.

It is worth noting that when analyzing gene mutations, Rv0678 gene mutations account for a high proportion, as high as 65.6%. This further points out that mutations in specific genes are closely related to bedaquiline resistance, suggesting that clinical and public health fields need to strengthen research on resistance mechanisms in order to propose more effective treatment strategies.

The researchers concluded that there is a growing trend in acquired bedaquiline resistance, highlighting the importance of whole-genome sequencing in understanding and managing drug-resistant Mycobacterium tuberculosis. Whole-genome sequencing technology can help researchers gain insights into the genetic variation of Mycobacterium tuberculosis and identify key mechanisms for the development of drug resistance. This will not only help track the spread of drug-resistant strains, but also provide a basis for personalized treatment, thereby improving the cure rate of drug-resistant tuberculosis.

In summary, the problem of drug resistance to bedaquiline/sneril in drug-resistant tuberculosis is a complex and important public health challenge. As drug resistance levels rise, surveillance, research and management of drug-resistant tuberculosis need to be strengthened globally.

Reference materials:https://en.wikipedia.org/wiki/Bedaquiline