TY - JOUR T1 - Rapid emergence of <em>Mycobacterium tuberculosis</em> bedaquiline resistance: lessons to avoid repeating past errors JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01719-2016 SP - 1601719 AU - Nicolas Veziris AU - Christine Bernard AU - Lorenzo Guglielmetti AU - Damien Le Du AU - Dhiba Marigot-Outtandy AU - Marie Jaspard AU - Eric Caumes AU - Isabelle Lerat AU - Christophe Rioux AU - Yazdan Yazdanpanah AU - Angelica Tiotiu AU - Nadine Lemaitre AU - Florence Brossier AU - Vincent Jarlier AU - Jerome Robert AU - Wladimir Sougakoff AU - Alexandra Aubry Y1 - 2016/12/20 UR - http://erj.ersjournals.com/content/early/2016/12/22/13993003.01719-2016.abstract N2 - Bedaquiline (BDQ) has demonstrated potent clinical activity against multidrug-resistant (MDR) and extensively drug-resistant (XDR) Mycobacterium tuberculosis complex strains [1–3]. It has now been used in &gt;50 countries, and it is estimated that ∼2500 patients had been treated with BDQ by the end of 2015. In spite of its recent clinical use, there are few reports of BDQ-resistant strains [4, 5]. Mutations in the rv0678 gene encoding the MmpL5 efflux pump repressor generate low-level BDQ resistance and clofazimine (CFZ) cross-resistance [6]. To our knowledge, this is the sole mechanism of BDQ resistance described in clinical strains [4, 5]. Despite its introduction in France in 2011 for XDR- and MDR-tuberculosis (TB) treatment, we report herein four BDQ-resistant cases, and discuss strategies to avoid a surge of BDQ resistance.Bedaquiline resistance appears rapidly both after treatment and in patients that have never been treated http://ow.ly/mxEM30604OFThe members of CNR MyRMA (Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux) are as follows: Emmanuelle Cambau, Laurent Raskine and Faïza Mougari (Assistance Publique Hôpitaux de Paris, Hôpitaux Universitaires Lariboisière-Saint Louis, Service de Bactériologie, Centre National de Référence des Mycobactéries et Résistance des Mycobactéries aux Antituberculeux (CNR-MyRMA), IAME, UMR 1137, INSERM, Univ Paris Diderot, Sorbonne Paris Cité, Paris, France).The members of the Tuberculosis consilium of the CNR MyRMA are as follows: Claire Andrejak (Service de Pneumologie et de Réanimation Respiratoire, CHU Sud, Amiens, France), Mathilde Fréchet-Jachym (Sanatorium, Centre Hospitalier de Bligny, Briis-sous-Forges, France), Guillaume Thouvenin (Service de Pneumologie Pédiatrique, Hôpital Armand Trousseau, Assistance Publique Hôpitaux de Paris (AP-HP), Centre National de Référence des Maladies Respiratoires Rares RespiRare, Paris, France and Inserm UMRS928, Université Pierre et Marie Curie, Sorbonne Universités, Paris), Katarina Chadelat (Hôpital d'Enfants Armand-Trousseau, AP-HP, Paris), Bertrand Dautzenberg (Hôpitaux Universitaires Pitié-Salpêtrière-Charles-Foix, AP-HP, Université Pierre-et-Marie-Curie, Paris), Najoua Helali (Clinical Microbiology Unit, Saint-Joseph Hospital Network, Paris) and Bénedictine Rivoire (Samu Social, Paris). ER -