Bedaquiline susceptibility testing of Mycobacterium abscessus complex and Mycobacterium avium complex: A meta-analysis study

Ming Wang; Peixuan Men; Weihe Zhang; Jing Wu; Yuzhen Gu; Fen Wang; Hairong Huang; Xia Yu; Hongfei Duan

doi:10.1016/j.jgar.2024.03.009

Bedaquiline susceptibility testing of Mycobacterium abscessus complex and Mycobacterium avium complex: A meta-analysis study

J Glob Antimicrob Resist. 2024 Mar 30:37:135-140. doi: 10.1016/j.jgar.2024.03.009. Online ahead of print.

Authors

Ming Wang¹, Peixuan Men², Weihe Zhang³, Jing Wu³, Yuzhen Gu³, Fen Wang³, Hairong Huang³, Xia Yu³, Hongfei Duan⁴

Affiliations

¹ Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing, China.
² Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
³ National Clinical Laboratory on Tuberculosis, Beijing Key Laboratory for Drug-Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, China.
⁴ Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing, China. Electronic address: duanhongfei@hotmail.com.

PMID: 38561143
DOI: 10.1016/j.jgar.2024.03.009

Abstract

Objective: This study aims to estimate the overall in vitro activity of bedaquiline (BDQ) against clinical isolates of Mycobacterium abscessus complex (MABS) and M. avium complex (MAC), considering BDQ as a repurposed drug for non-tuberculous mycobacteria (NTM) infections.

Methods: We conducted a systematic review of publications in PubMed/ MEDLINE, Web of Science, and Embase up to 15 April 2023. Studies were included if they followed the Clinical and Laboratory Standards Institute (CLSI) criteria for drug susceptibility testing (DST). Using a random effects model, we assessed the overall in vitro BDQ resistance rate in clinical isolates of MABS and MAC. Sources of heterogeneity were analysed using Cochran's Q and the I² statistic. All analyses were performed using CMA V3.0.

Results: A total of 24 publications (19 reports for MABS and 11 for MAC) were included. Using 1 µg/mL and 2 µg/mL as the breakpoint for BDQ resistance, the pooled rates of in vitro BDQ resistance in clinical isolates of MABS were found to be 1.8% (95% confidence interval [CI], 0.7-4.6%) and 1.7% (95% CI, 0.6-4.4%), respectively. In the case of MAC, the pooled rates were 1.7% (95% CI, 0.4-6.9%) and 1.6% (95% CI, 0.4-6.8%) for 1 µg/mL and 2 µg/mL, respectively.

Conclusion: This study reports the prevalence of BDQ resistance in clinical isolates of MABS and MAC. The findings suggest that BDQ holds potential as a repurposed drug for treating MABS and MAC infections.

Keywords: Drug susceptibility testing; In vitro; Mycobacterium abscessus complex; Mycobacterium avium complex.

Publication types

Review