{"title":"Bedaquiline resistance: a predictable consequence of a game-changing drug?","authors":"Ronald Lubelchek","doi":"10.1128/asmcr.00228-25","DOIUrl":null,"url":null,"abstract":"<p><p>Bedaquiline's (BDQ) incorporation into the recommended treatment for drug-resistant tuberculosis (DR-TB) has ushered in a new era of highly effective, shorter course, all-oral regimens. Unfortunately, as the uptake of BDQ-based regimens has increased, so has the emergence of BDQ resistance. In a recent <i>ASM Case Reports</i> article, M. Richard-Greenblatt, R. Bagga, C. Duncan, M. J. Billick, et al. (ASM Case Rep 2:e00126-25, 2025, https://doi.org/10.1128/asmcr.00126-25) reported on a patient with treatment-emergent extensively drug-resistant (XDR) TB, whose isolate harbored a novel loss-of-function <i>pepQ</i> mutation, with resulting BDQ resistance. This commentary briefly highlights the benefits of BDQ-based DR-TB therapy, while also reviewing data related to the growing challenge posed by BDQ resistance.</p>","PeriodicalId":521101,"journal":{"name":"ASM case reports","volume":"2 4","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13340198/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ASM case reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1128/asmcr.00228-25","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/7/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Bedaquiline's (BDQ) incorporation into the recommended treatment for drug-resistant tuberculosis (DR-TB) has ushered in a new era of highly effective, shorter course, all-oral regimens. Unfortunately, as the uptake of BDQ-based regimens has increased, so has the emergence of BDQ resistance. In a recent ASM Case Reports article, M. Richard-Greenblatt, R. Bagga, C. Duncan, M. J. Billick, et al. (ASM Case Rep 2:e00126-25, 2025, https://doi.org/10.1128/asmcr.00126-25) reported on a patient with treatment-emergent extensively drug-resistant (XDR) TB, whose isolate harbored a novel loss-of-function pepQ mutation, with resulting BDQ resistance. This commentary briefly highlights the benefits of BDQ-based DR-TB therapy, while also reviewing data related to the growing challenge posed by BDQ resistance.
贝达喹啉（BDQ）被纳入耐药结核病（DR-TB）的推荐治疗方案，开创了高效、短疗程、全口服治疗方案的新时代。不幸的是，随着以BDQ为基础的治疗方案的增加，BDQ耐药性的出现也越来越多。在最近的一篇ASM病例报告文章中，M. Richard-Greenblatt， R. Bagga， C. Duncan， M. J. Billick等人（ASM病例报告2:e00126- 25,2025, https://doi.org/10.1128/asmcr.00126-25）报道了一名治疗出现的广泛耐药（XDR）结核病患者，其分离物携带一种新的功能丧失pepQ突变，导致BDQ耐药。本评论简要强调了以BDQ为基础的耐药结核病治疗的益处，同时也回顾了BDQ耐药性带来的日益严峻挑战的相关数据。
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