{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:38:27Z","timestamp":1790865507053,"version":"4.1.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bedaquiline (BDQ) resistance presents a critical challenge in the fight against tuberculosis (TB), particularly multidrug-resistant (MDR) strains. The emergence of resistance to BDQ, a key drug in treating MDR-TB, poses significant threats to TB treatment effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The National Institute of Tuberculosis and Respiratory Diseases in Delhi and the M\u00e9decins Sans Fronti\u00e8res clinic in Mumbai provide BDQ, delamanid, and carbapenem-based regimens for patients with suspected or confirmed treatment failure. BDQ phenotypic drug-susceptibility testing (DST) was performed for all BDQ-exposed patients. Treatment regimens were individualized based on exposure history, comorbidities, drug interactions, prior adverse drug reactions, and DST results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 117 BDQ-exposed patients from December 2020\u2013December 2022, 42 (36%) exhibited a BDQ-resistant strain. Median (IQR) age was 24 (22\u201332) years, with 63 (54%) females and 94% with pulmonary TB. Patients with a BDQ-resistant strain were older (median age: 27 vs 23 years; P = .04), more likely to have lung cavities (risk ratio [RR]: 1.8; 95%-CI: 1.1\u20133.1; P = .02), and be resistant to clofazimine (RR: 2.3; 95%-CI: 1.5\u20133.6; P = .001). Overall, 102 patients initiated treatment. Patients with BDQ-resistance had higher risk of unfavorable outcomes compared with BDQ-susceptible patients (RR:2.1; 95%-CI: 1.5\u20132.8; P &amp;lt; .001). Overall, 87% (33\/38) of patients with BDQ-resistance experienced unfavorable treatment outcomes: 15 (40%) died, 15 (40%) had treatment failure, and 3 (8%) were lost-to-follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study highlights a concerning rate of BDQ-resistance among previously treated patients, resulting in poor treatment outcomes. To prevent treatment failure, we recommend implementing BDQ-DST, developing affordable and accurate rapid tests for BDQ-resistance, and intensifying research and development efforts for newer TB drugs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf068","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T07:26:10Z","timestamp":1739431570000},"page":"846-852","source":"Crossref","is-referenced-by-count":12,"title":["Bedaquiline Resistance and Treatment Outcomes Among Patients With Tuberculosis Previously Exposed to Bedaquiline in India: A Multicentric Retrospective Cohort Study"],"prefix":"10.1093","volume":"81","author":[{"given":"Rupak","family":"Singla","sequence":"first","affiliation":[{"name":"National Institute of Tuberculosis and Respiratory Diseases , New Delhi ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6257-0752","authenticated-orcid":false,"given":"Samsuddin","family":"Khan","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res , Mumbai ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arunima","family":"Silsarma","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res , Mumbai ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3563-6896","authenticated-orcid":false,"given":"Vijay","family":"Chavan","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res , Mumbai 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Respiratory Diseases , New Delhi ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manpreet","family":"Bhalla","sequence":"additional","affiliation":[{"name":"National Institute of Tuberculosis and Respiratory Diseases , New Delhi ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavish","family":"Kumar","sequence":"additional","affiliation":[{"name":"National Institute of Tuberculosis and Respiratory Diseases , New Delhi ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pramila","family":"Singh","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res , Mumbai ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aparna","family":"Iyer","sequence":"additional","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res , Mumbai 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