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In July of last year, South Africa became the first country to incorporate a new anti-tuberculosis drug into its national program.
Bedaquiline, the new drug, is the first new anti-tuberculosis drug in four decades. It improves the survival of patients with multidrug-resistant TB, potentially offering a shorter duration of treatment with fewer side effects.
Scientists from the University of Stellenbosch (SU), in collaboration with a multidisciplinary team of researchers and clinicians, are now trying to preserve this vital treatment by studying how Mycobacterium tuberculosis, the bacterium causing tuberculosis may develop resistance to this medicine. Their findings will be used to inform tuberculosis treatment guidelines to ensure that the right combination of TB drugs and bedaquiline is used to optimize patient treatment outcomes, while minimizing the risk of developing resistance. to the drug.
"We need to protect bedaquiline from the development of resistance, so it's crucial to understand how fast and through what mechanisms resistance to bedaquiline develops," says Dr. Margaretha de Vos, one of the main authors of a scientific commentary article recently published in the New England Journal of Medicine. The article is based on the research of De Vos and his colleagues in the Division of Molecular Biology and Human Genetics of the Faculty of Medicine and Health Sciences of the Southern University (FMHS).
League researchers have studied the development of bedaquiline resistance in tuberculosis bacteria in a 65-year-old Cape patient using a combination of innovative techniques. These included (1) sequencing of the entire genome of the bacterium in patient samples taken during the different stages of the disease, (2) targeted deep sequencing of Rv0678, a resistance-badociated bacterium gene. to bedaquiline, and (3) culture drug-based susceptibility testing.
The study showed that resistance to bedaquiline appeared despite the patient's adherence to the standard regimen, which requires taking bedaquiline with at least five antibiotics that the bacteria can not resist.
"These results show that it is crucial to intensify our efforts to monitor patients receiving bedaquiline and to develop new diagnostic tools to quickly identify resistance to bedaquiline." resistance to bedaquiline, we will be able to change treatment and prevent its spread, "says Rob Warren, a distinguished microbiology professor and co-author of the article.
Helen Cox, one of the major co-authors of the study, believes that "while it is important to monitor the emergence of resistance to new drugs such as bedaquiline, these data need only not suggest that we limit access to bedaquiline for thousands of patients in South Africa who are in dire need of improved treatment for drug-resistant TB. "
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Material provided by University of Stellenbosch. Note: Content can be changed for style and length.
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