Bedaquiline resistance in Mycobacterium tuberculosis during antimycobacterial therapy and its impact on clinical outcomes (clinical cases)

Authors

DOI:

https://doi.org/10.14739/2310-1210.2023.1.268009

Keywords:

multidrug-resistant tuberculosis, bedaquiline, results

Abstract

Aim. To analyze the nature of Bedaquiline (Bdq) resistance in Mycobacterium tuberculosis (MBT) during antimycobacterial therapy (AMBT) in patients with multidrug-resistant tuberculosis (MDR-TB), its impact on clinical outcomes and to detect risk factors for the Bdq drug resistance development on the example of own observed clinical cases.

Materials and methods. 2 clinical cases of own observations of the Bdq resistance development in MBT during AMBT in patients with MDR-TB who were treated at the clinical base of the Department of Phthisiology and Pulmonology of Zaporizhzhia State Medical University – Pulmonary Tuberculosis Department No. 2 of the Communal Non-profit Organization “Zaporizhzhia Regional Phthisio-Pulmonology Clinical Treatment and Diagnostic Center” are presented.

Results. The presented clinical cases confirm the literature data that the treatment effectiveness in patients with Rifampicin-resistant TB (RR-TB) and MDR-TB is associated with Bdq drug resistance. Regarding the reasons for the development of acquired Bdq drug resistance, the second clinical case, like the examples of other authors, demonstrates low adherence to treatment. There is no data in the literature about the lack of controlled treatment at the outpatient stage as a risk factor for Bdq drug resistance and negative clinical outcomes in patients with MDR-TB, which would complement the scientific experience in this problem.

Conclusions. In both clinical cases, Bdq drug resistance was acquired (secondary), and had an impact on the clinical outcomes of tuberculosis treatment. The risk factors for Bdq drug resistance and negative clinical outcomes were lack of controlled treatment at the outpatient stage in the first case and low adherence to treatment in the second one.

Author Biographies

O. M. Raznatovska, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Phthisiology and Pulmonology

R. M. Yasinskyi, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Associate Professor of the Department of Phthisiology and Pulmonology

O. S. Shalmin, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor of the Department of Phthisiology and Pulmonology

A. V. Fedorets, Zaporizhzhia State Medical University, Ukraine

MD, Assistant of the Department of Phthisiology and Pulmonology

O. A. Svitlytska, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Assistant of the Department of Phthisiology and Pulmonology

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Published

2023-03-06

How to Cite

1.
Raznatovska OM, Yasinskyi RM, Shalmin OS, Fedorets AV, Svitlytska OA. Bedaquiline resistance in Mycobacterium tuberculosis during antimycobacterial therapy and its impact on clinical outcomes (clinical cases). Zaporozhye Medical Journal [Internet]. 2023Mar.6 [cited 2024Jul.20];25(1):87-96. Available from: http://zmj.zsmu.edu.ua/article/view/268009