MDR M. tuberculosis outbreak clone in Eswatini missed by Xpert has elevated bedaquiline resistance dated to the pre-treatment era.
Patrick BeckertElisabeth Sanchez-PadillaMatthias MerkerViola DreyerThomas A KohlChristian UtpatelClaudio U KöserIvan BarilarNazir IsmailShaheed Vally OmarMarisa KlopperRobin M WarrenHarald HoffmannGugu MaphalalaElisa ArdizzoniBouke C de JongBernhard KerschbergerBirgit SchrammSönke AndresKatharina KranzerFlorian P MaurerMaryline BonnetStefan NiemannPublished in: Genome medicine (2020)
The high clustering rate suggests that transmission has been driving the MDR-TB epidemic in Eswatini for three decades. The presence of MDR strains in Eswatini that are not detected by commercial mDST assays and have elevated MICs to BDQ and CFZ potentially jeopardizes the successful implementation of new MDR-TB treatment guidelines. Measures to limit the spread of these outbreak isolates need to be implemented urgently.