Identification of genetic determinants of bedaquiline resistance in Mycobacterium tuberculosis in Ural region, Russia

Collecting data on rare Mycobacterium tuberculosis (Mtb) clinical isolates with resistance to the new anti-tuberculosis drug bedaquiline is an important task for improving antimicrobial susceptibility testing methods. Nanopore whole genome sequencing, the proportion method on Middlebrook 7H11 medium, and BACTEC MGIT 960 assays were used to analyze genotypic and phenotypic resistance to bedaquiline. We found four mutations: atpE I66M, atpE A63P, Rv0678 A36T, and Rv0678 S53P in five isolates with different levels of phenotypic bedaquiline resistance.