Articles Vol. 66 No. CĐ8-NCKH 21/08/2025

58. AMPLIFICATION OF RESISTANCE TO NEW TB DRUG “BEDAQUILINE” IN TUBERCULOSIS PATIENT AFTER COMPLETION OF TREATMENT.

Hoang Thi Thanh Thuy1,2, Bui Thi Ngoc3,4
1 National Lung Hospital
2 Bệnh viện Phổi Trung ương
3 Hai Duong Lung Hospital
4 Bệnh viện Phổi Hải Dương
Corresponding author: hoangthanht@gmail.com
DOI: 10.52163/yhc.v66iCD8.3019
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Keywords
Drug-resistant tuberculosis Bedaquiline resistance drug susceptibility testing treatment monitoring, treatment completion
Abstract

Objective: We report a case of stepwise amplification of drug resistance to the new drug - Bedaquiline in a tuberculosis (TB) patient previously assessed as having completed treatment, with the hope of sharing information to improve the quality of treatment monitoring.

Case report: A 58-year-old male patient with a history of two previous TB treatments was assessed as “complete”. Initially a case of drug-sensitive TB, the patient was found to have developed stepwise resistance to Rifampicin, Fluoroquinolones and especially the new drug “Bedaquiline”.

Discussion: Although there was no evidence of bacterial genome sequencing to exclude the possibility of infection with new strains, or heteroresistance; this case still points towards the possibility of acquired drug resistance due to no history of contact with a drug-resistant TB patient or use of second-line drugs idientified; meanwhile, the patient lacked compliance and re-examination in the final stage of treatment to have sufficient evidence for  accurate treatment outcome assessment.

Conclusion: Vietnam needs solutions to improve the quality of treatment monitoring, re-examination during treatment, and monitoring TB patients after completing treatment to promptly detect and treat cases of relapse with drug resistance amplification.

Keywords: Drug-resistant tuberculosis, Bedaquiline resistance, drug susceptibility testing, treatment monitoring, treatment completion

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