Primary clofazimine and bedaquiline resistance among isolates from patients with multidrug-resistant tuberculosis

Jian Xu, Bin Wang, Minghao Hu, Fengmin Huo, Shaochen Guo, Wei Jing, Eric Nuermberger, Yu Lu

Research output: Research - peer-reviewArticle

Abstract

Clofazimine has been repurposed for the treatment of tuberculosis, especially for multidrug-resistant tuberculosis (MDR-TB). To test the susceptibility to clofazimine of Mycobacterium tuberculosis clinical isolates, MICs of clofazimine were determined using the microplate alamarBlue assay (MABA) method for 80 drugresistant isolates and 10 drug-susceptible isolates for comparison. For five clofazimineresistant strains isolated from previously treated pre-extensively drug-resistant TB (pre- XDR-TB) and XDR-TB patients without prior exposure to clofazimine or bedaquiline, clofazimine MICs were u1.2 ug/ml. Four isolates with cross-resistance to bedaquiline had Rv0678 mutations. The other isolate with no resistance to bedaquiline had an Rv1979c mutation. This study adds to a recent study showing that 6.3% of MDR-TB patients without prior clofazimine or bedaquiline exposure harbored isolates with Rv0678 mutations, which raises concern that preexisting resistance to these drugs may be associated with prior TB treatment. Furthermore, we propose a tentative breakpoint of 1.2 ug/ml for clofazimine resistance using the MABA method. Morewidespread surveillance and individualized testing for clofazimine and bedaquiline resistance, together with assessment of their clinical usage, especially among previously treated and MDR-TB patients, are warranted.

LanguageEnglish (US)
Article numbere00239-17
JournalAntimicrobial Agents and Chemotherapy
Volume61
Issue number6
DOIs
StatePublished - Jun 1 2017

Fingerprint

bedaquiline
Clofazimine
Multidrug-Resistant Tuberculosis
Mutation
Pharmaceutical Preparations
Therapeutics
resazurin
Extensively Drug-Resistant Tuberculosis
Mycobacterium tuberculosis
Drug Resistance
Tuberculosis

Keywords

  • Bedaquiline
  • Clofazimine
  • Mycobacterium tuberculosis
  • Resistance
  • Rv0678

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Primary clofazimine and bedaquiline resistance among isolates from patients with multidrug-resistant tuberculosis. / Xu, Jian; Wang, Bin; Hu, Minghao; Huo, Fengmin; Guo, Shaochen; Jing, Wei; Nuermberger, Eric; Lu, Yu.

In: Antimicrobial Agents and Chemotherapy, Vol. 61, No. 6, e00239-17, 01.06.2017.

Research output: Research - peer-reviewArticle

Xu, Jian ; Wang, Bin ; Hu, Minghao ; Huo, Fengmin ; Guo, Shaochen ; Jing, Wei ; Nuermberger, Eric ; Lu, Yu. / Primary clofazimine and bedaquiline resistance among isolates from patients with multidrug-resistant tuberculosis. In: Antimicrobial Agents and Chemotherapy. 2017 ; Vol. 61, No. 6.
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