Abstract：
OBJECTIVE: This study aims to estimate the overall in vitro activity of bedaquiline (BDQ) against clinical isolates of Mycobacterium abscessus complex (MABS) and M. avium complex (MAC), considering BDQ as a repurposed drug for non-tuberculous mycobacteria (NTM) infections.
METHODS: We conducted a systematic review of publications in PubMed/ MEDLINE, Web of Science, and Embase up to 15 April 2023. Studies were included if they followed the Clinical and Laboratory Standards Institute (CLSI) criteria for drug susceptibility testing (DST). Using a random effects model, we assessed the overall in vitro BDQ resistance rate in clinical isolates of MABS and MAC. Sources of heterogeneity were analysed using Cochran\'s Q and the I2 statistic. All analyses were performed using CMA V3.0.
RESULTS: A total of 24 publications (19 reports for MABS and 11 for MAC) were included. Using 1 µg/mL and 2 µg/mL as the breakpoint for BDQ resistance, the pooled rates of in vitro BDQ resistance in clinical isolates of MABS were found to be 1.8% (95% confidence interval [CI], 0.7-4.6%) and 1.7% (95% CI, 0.6-4.4%), respectively. In the case of MAC, the pooled rates were 1.7% (95% CI, 0.4-6.9%) and 1.6% (95% CI, 0.4-6.8%) for 1 µg/mL and 2 µg/mL, respectively.
CONCLUSIONS: This study reports the prevalence of BDQ resistance in clinical isolates of MABS and MAC. The findings suggest that BDQ holds potential as a repurposed drug for treating MABS and MAC infections.
METHODS: We conducted a systematic review of publications in PubMed/ MEDLINE, Web of Science, and Embase up to 15 April 2023. Studies were included if they followed the Clinical and Laboratory Standards Institute (CLSI) criteria for drug susceptibility testing (DST). Using a random effects model, we assessed the overall in vitro BDQ resistance rate in clinical isolates of MABS and MAC. Sources of heterogeneity were analysed using Cochran\'s Q and the I2 statistic. All analyses were performed using CMA V3.0.
RESULTS: A total of 24 publications (19 reports for MABS and 11 for MAC) were included. Using 1 µg/mL and 2 µg/mL as the breakpoint for BDQ resistance, the pooled rates of in vitro BDQ resistance in clinical isolates of MABS were found to be 1.8% (95% confidence interval [CI], 0.7-4.6%) and 1.7% (95% CI, 0.6-4.4%), respectively. In the case of MAC, the pooled rates were 1.7% (95% CI, 0.4-6.9%) and 1.6% (95% CI, 0.4-6.8%) for 1 µg/mL and 2 µg/mL, respectively.
CONCLUSIONS: This study reports the prevalence of BDQ resistance in clinical isolates of MABS and MAC. The findings suggest that BDQ holds potential as a repurposed drug for treating MABS and MAC infections.
摘要：
目的：本研究旨在评估bedaquiline（BDQ）对脓肿分枝杆菌复合体（MABS）和鸟分枝杆菌复合体（MAC）临床分离株的总体体外活性，考虑BDQ作为非结核分枝杆菌（NTM）感染的再用途药物。
方法：我们对PubMed/MEDLINE，WebofScience,和Embase至2023年4月15日。如果研究遵循临床和实验室标准研究所（CLSI）的药物敏感性测试（DST）标准，则将其纳入研究。使用随机效应模型，我们评估了MABS和MAC临床分离株的体外总BDQ耐药率.使用Cochran'sQ和I2统计量分析异质性的来源。所有分析均使用CMAV3.0进行。
结果：共纳入24篇出版物（19篇关于MABS的报告和11篇关于MAC的报告）。使用1μg/mL和2μg/mL作为BDQ抗性的断点，发现MABS临床分离株中体外BDQ耐药的合并率为1.8%(95%置信区间[CI]，0.7-4.6%)和1.7%(95%CI，0.6-4.4%)，分别。在MAC的情况下，1μg/mL和2μg/mL的合并率为1.7％（95％CI，0.4-6.9％）和1.6％（95％CI，0.4-6.8％），分别。
结论：本研究报告了临床分离株MABS和MAC对BDQ的耐药率。研究结果表明，BDQ具有作为治疗MABS和MAC感染的再用途药物的潜力。
方法：我们对PubMed/MEDLINE，WebofScience,和Embase至2023年4月15日。如果研究遵循临床和实验室标准研究所（CLSI）的药物敏感性测试（DST）标准，则将其纳入研究。使用随机效应模型，我们评估了MABS和MAC临床分离株的体外总BDQ耐药率.使用Cochran'sQ和I2统计量分析异质性的来源。所有分析均使用CMAV3.0进行。
结果：共纳入24篇出版物（19篇关于MABS的报告和11篇关于MAC的报告）。使用1μg/mL和2μg/mL作为BDQ抗性的断点，发现MABS临床分离株中体外BDQ耐药的合并率为1.8%(95%置信区间[CI]，0.7-4.6%)和1.7%(95%CI，0.6-4.4%)，分别。在MAC的情况下，1μg/mL和2μg/mL的合并率为1.7％（95％CI，0.4-6.9％）和1.6％（95％CI，0.4-6.8％），分别。
结论：本研究报告了临床分离株MABS和MAC对BDQ的耐药率。研究结果表明，BDQ具有作为治疗MABS和MAC感染的再用途药物的潜力。
