TY - T1的结核病高负担国家出现bedaquiline-resistance JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.00621 -2021欧元SP - 2100621 AU Chesov Elena盟——Chesov Dumitru AU -毛雷尔,Florian p . AU -安德烈斯,snoke盟——Utpatel基督教非盟- Barilar,伊凡盟多,安娜盟——ReimannMaja AU - Niemann, Stefan AU - Lange, Christoph AU - Crudu, Valeriu AU - Heyckendorf, Jan AU - Merker，Bedaquiline已被世界卫生组织列为治疗耐多药结核病(MDR-TB)的a组药物。然而，全球出现的耐药性威胁到新型耐多药结核病治疗方案的有效性。我们分析了基于bedaquiline的耐多药结核病治疗中既存的和新出现的bedaquiline耐药性，以及与治疗失败和死亡相关的危险因素。方法在一项横断面队列研究中，我们使用了患者数据、全基因组测序(WGS)和结核分枝杆菌复合体(MTBC)分离株的表型。在摩尔多瓦共和国2016年至2018年期间接受贝达奎林治疗的所有耐多药结核病患者中，我们可以检索30.5%(62/203)的基线分离株。这包括26名患者，我们也可以对他们进行随访隔离。基线时，所有MTBC分离株均对贝达奎林敏感。在26例可获得基线和随访分离株的患者中，4/26(15.3%)患者在治疗中携带了获得bedquiline耐药菌株，1/26(3.8%)患者再次感染了第二个bedquiline耐药菌株。治疗失败和死亡与空洞性疾病相关(p=0.011)，且基线时含bedaquiline的方案中任何额外处方的药物均具有wgs预测的耐药性(p=0.012, OR 1.92 /单位增加，95%CI 1.15-3.21)。结论基于bedaquiline的耐多药结核病治疗需要一个功能背景方案，以达到高治愈率和防止bedaquiline耐药的演变。 Novel MDR-TB therapies with bedaquiline require timely and comprehensive drug resistance monitoring.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Chesov has nothing to disclose.Conflict of interest: Dr. Chesov has nothing to disclose.Conflict of interest: Dr. Maurer has nothing to disclose.Conflict of interest: Dr. Andres has nothing to disclose.Conflict of interest: Dr. Utpatel has nothing to disclose.Conflict of interest: Dr. Barilar has nothing to disclose.Conflict of interest: Dr. Donica has nothing to disclose.Conflict of interest: Dr. Reimann has nothing to disclose.Conflict of interest: Dr. Niemann reports grants from EXC 2167 Precision Medicine in Inflammation, grants from Leibniz Science Campus Evolutionary Medicine of the LUNG , grants from German Center for Infection Research, during the conduct of the study.Conflict of interest: Dr. Lange reports personal fees from Chiesi, Gilead, Janssen, Novartis, Oxfordimmunotec and Insmed, outside the submitted work.Conflict of interest: Dr. Crudu has nothing to disclose.Conflict of interest: Dr. Heyckendorf has nothing to disclose.Conflict of interest: Dr. Merker has nothing to disclose. ER -