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The following is a summary of “Prevalence of bedaquiline resistance in patients with drug-resistant tuberculosis: a systematic review and meta-analysis,” published in the May 2025 issue of BMC Infectious Diseases by Hu et al. 

Researchers conducted a retrospective study to analyze the emergence of bedaquiline (BDQ) resistance in individuals treated for multi-drug-resistant tuberculosis (TB).  

They assessed the prevalence of BDQ resistance, using data from PubMed, Web of Science, and Embase. Sensitivity and subgroup analyses were applied to identify heterogeneity and compare prevalence across populations. The methodological quality of the studies included was appraised using the Joanna Briggs Institute’s checklist. Heterogeneity was assessed with Cochran’s Q and I² statistics. This review was registered with PROSPERO (CRD42024620791).  

The results showed that the average prevalence of BDQ resistance was 5.7% (95% CI: 3.6–8.3), with acquired resistance at 5.4%. High-quality studies reported a prevalence of 5.2%, while fair-quality studies reported 7.7%. Mutations in the Rv0678 gene accounted for a large proportion, reaching up to 65.6%.  

Investigators concluded that the growing trend in acquired BDQ resistance highlighted the importance of whole-genome sequencing in understanding and managing drug-resistant Mycobacterium tuberculosis. 

Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-11067-2