Mutations in the genes of the F₄₂₀ signaling pathway of Mycobacterium tuberculosis complex, including dnn, fgd1, fbiA, fbiB, fbiC, and fbiD, can lead to delamanid resistance. We searched for such mutations among 129 M. tuberculosis strains from Asia, South America, and Africa using whole-genome sequencing; 70 (54%) strains had at least one mutation in one of the genes. For 10 strains with mutations, we determined the MIC of delamanid. We found one strain from a delamanid-naive patient carrying the natural polymorphism Tyr29del (ddn) that was associated with a critical delamanid MIC.

中文翻译：

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结核分枝杆菌的天然多态性赋予初治患者对德拉马尼的耐药性。


结核分枝杆菌复合体 F ₄₂₀信号通路基因（包括dnn 、 fgd1 、 fbiA 、 fbiB 、 fbiC和fbiD ）的突变可导致 delamanid 耐药。我们使用全基因组测序在来自亚洲、南美洲和非洲的 129 种结核分枝杆菌菌株中寻找此类突变； 70 个（54%）菌株的其中一个基因至少有一个突变。对于 10 个突变菌株，我们测定了德拉马尼的 MIC。我们发现一种来自未接受过 delamanid 治疗的患者的菌株携带天然多态性 Tyr29del ( ddn )，该多态性与关键的 delamanid MIC 相关。