{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T02:48:25Z","timestamp":1792896505533,"version":"4.5.0"},"reference-count":25,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJTLD Open"],"accepted":{"date-parts":[[2025,12,12]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>\n                      WHO recommends the bedaquiline\u2013pretomanid\u2013linezolid regimen with\/without moxifloxacin (M) (BPaL\/M) for the treatment of multidrug- or rifampicin-resistant TB. However,\n                      <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                      (MTB) lineage 1 (L1) is less susceptible to pretomanid than other lineages, and there are limited BPaL\/M efficacy data from regions where L1 is prevalent.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We performed whole genome sequencing (WGS) on baseline MTB isolates from a subgroup (34\/103) of patients from the highly successful Philippine BPaL Operational Research Study to characterise their lineage and genotypic drug susceptibility testing (DST) profile. Phenotypic DST for BPaL drugs was also conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>WGS analysis showed that L1 (68%) predominated, followed by L4 (26%) and L2 (6%). Out of the 22 L1 isolates tested, 20 exhibited higher pretomanid minimum inhibitory concentrations than isolates from other lineages, including one with borderline resistance. Two patients had confirmed bedaquiline resistance; no linezolid resistance was detected. All 34 patients with characterised isolates had culture converted by end of treatment. At month 12 follow-up, 30\/31 patients who provided sputum remained culture negative; the single culture-positive participant harboured MTB L4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>In this study, patients infected with MTB L1 responded to BPaL as well as those infected with other lineages. Baseline bedaquiline resistance was linked to the unique recurrence in the study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5588\/ijtldopen.25.0677","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T14:13:03Z","timestamp":1776262383000},"page":"226-231","source":"Crossref","is-referenced-by-count":2,"title":["High efficacy of BPaL among patients infected with\n                    <i>Mycobacterium tuberculosis<\/i>\n                    lineage 1 in the Philippines"],"prefix":"10.5588","volume":"3","author":[{"given":"I.","family":"Flores","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.A.A.","family":"Tujan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Basilio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.J.R.","family":"Dizon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.R","family":"Lim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.T.","family":"Reyes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.V.A.G.","family":"Reyes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Rojas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.K.","family":"Valencia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.B.","family":"Capin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Mirtskhulava","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.G.","family":"Palparan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Cabalitan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.J.","family":"Carpin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Malbacias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.S.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Gebhard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Quelapio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Timm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3554","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"2026041507125824000_3.4.226.1","unstructured":"World Health Organization . WHO treatment guidelines for drug-resistant tuberculosis: 2016 update. Geneva: WHO, 2016."},{"key":"2026041507125824000_3.4.226.2","unstructured":"World Health Organization . Communication rapid: key changes to the treatment of drug-resistant tuberculosis. Geneva: WHO, 2019."},{"key":"2026041507125824000_3.4.226.3","unstructured":"World Health Organization . WHO operational handbook on tuberculosis. module 4: treatment - drug-resistant tuberculosis treatment, 2022 update. Geneva: WHO, 2022."},{"key":"2026041507125824000_3.4.226.4","unstructured":"World Health Organization . Global tuberculosis report 2024. Geneva: WHO, 2024."},{"issue":"11","key":"2026041507125824000_3.4.226.5","doi-asserted-by":"crossref","first-page":"e0310773","DOI":"10.1371\/journal.pone.0310773","article-title":"Introducing BPaL: experiences from countries supported under the LIFT-TB project","volume":"19","author":"Wares","year":"2024","journal-title":"PLoS One"},{"key":"2026041507125824000_3.4.226.6","doi-asserted-by":"crossref","first-page":"100567","DOI":"10.1016\/j.jctube.2025.100567","article-title":"Effectiveness and safety of the BPaL regimen in the Philippines","volume":"41","author":"Flores","year":"2025","journal-title":"J Clin Tuberc Other Mycobacter Dis"},{"key":"2026041507125824000_3.4.226.7","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkac070"},{"key":"2026041507125824000_3.4.226.8","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-70471-x"},{"key":"2026041507125824000_3.4.226.9","unstructured":"World Health Organization . Catalogue of mutations in Mycobacterium tuberculosis complex and their association with drug resistance. 2nd ed. Geneva: WHO, 2023."},{"issue":"10","key":"2026041507125824000_3.4.226.10","doi-asserted-by":"crossref","first-page":"e0002283","DOI":"10.1371\/journal.pgph.0002283","article-title":"Baseline and acquired resistance to bedaquiline, linezolid and pretomanid, and impact on treatment outcomes in four tuberculosis clinical trials containing pretomanid","volume":"3","author":"Timm","year":"2023","journal-title":"PLoS Glob Public Health"},{"issue":"10","key":"2026041507125824000_3.4.226.11","doi-asserted-by":"crossref","first-page":"e0274549","DOI":"10.1371\/journal.pone.0274549","article-title":"Effect of HIV status and antiretroviral treatment on treatment outcomes of tuberculosis patients in a rural primary healthcare clinic in South Africa","volume":"17","author":"Nyasulu","year":"2022","journal-title":"PLoS One"},{"key":"2026041507125824000_3.4.226.12","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-024-01025-1"},{"issue":"12","key":"2026041507125824000_3.4.226.13","doi-asserted-by":"crossref","first-page":"e972","DOI":"10.1016\/S2666-5247(23)00172-6","article-title":"Bedaquiline resistance in patients with drug-resistant tuberculosis in Cape Town, South Africa: a retrospective longitudinal cohort study","volume":"4","author":"Derendinger","year":"2023","journal-title":"Lancet Microbe"},{"key":"2026041507125824000_3.4.226.14","unstructured":"Web Annex B . Critical concentrations for pretomanid and cycloserine: WHO policy statement. In: WHO operational handbook on tuberculosis. Module 3: diagnosis - rapid diagnostics for tuberculosis detection. 3rd ed. Geneva: WHO, 2024."},{"key":"2026041507125824000_3.4.226.15","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-45566-5"},{"key":"2026041507125824000_3.4.226.16","doi-asserted-by":"publisher","DOI":"10.1172\/JCI173156"},{"key":"2026041507125824000_3.4.226.17","doi-asserted-by":"publisher","DOI":"10.3201\/eid3003.231466"},{"key":"2026041507125824000_3.4.226.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2021.104802"},{"issue":"3","key":"2026041507125824000_3.4.226.19","doi-asserted-by":"crossref","first-page":"e0007024","DOI":"10.1128\/spectrum.00070-24","article-title":"Refined understanding of the impact of the Mycobacterium tuberculosis complex diversity on the intrinsic susceptibility to pretomanid","volume":"12","author":"Rupasinghe","year":"2024","journal-title":"Microbiol Spectr"},{"issue":"8","key":"2026041507125824000_3.4.226.20","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/S1473-3099(25)00357-3","article-title":"Balancing promise and peril: risk management in India's BPaL introduction","volume":"25","author":"Tirlangi","year":"2025","journal-title":"Lancet Infect Dis"},{"key":"2026041507125824000_3.4.226.21","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae388"},{"key":"2026041507125824000_3.4.226.22","doi-asserted-by":"crossref","first-page":"100408","DOI":"10.1016\/j.jctube.2023.100408","article-title":"The use of BPaL containing regimen in the MDR\/PreXDR TB treatments in Thailand","volume":"34","author":"Sangsayunh","year":"2024","journal-title":"J Clin Tuberc Other Mycobact Dis"},{"issue":"5","key":"2026041507125824000_3.4.226.23","doi-asserted-by":"crossref","first-page":"284","DOI":"10.5588\/ijtldopen.24.0524","article-title":"Treatment success rate and time to culture conversion under a prospective BPaL cohort study","volume":"2","author":"Burhan","year":"2025","journal-title":"IJTLD Open"},{"key":"2026041507125824000_3.4.226.24","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00391-2024"},{"issue":"12","key":"2026041507125824000_3.4.226.25","doi-asserted-by":"crossref","first-page":"100909","DOI":"10.1016\/S2666-5247(24)00149-6","article-title":"Bedaquiline: what might the future hold?","volume":"5","author":"Shaw","year":"2024","journal-title":"Lancet Microbe"}],"container-title":["IJTLD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.5588\/ijtldopen.25.0677","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T14:13:07Z","timestamp":1776262387000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.theunion.org\/lookup\/doi\/10.5588\/ijtldopen.25.0677"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":25,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4,1]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.5588\/ijtldopen.25.0677"],"URL":"https:\/\/doi.org\/10.5588\/ijtldopen.25.0677","relation":{},"ISSN":["3005-7590"],"issn-type":[{"value":"3005-7590","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}