Frequency of Resistance to Delamanid in Mycobacterium tuberculosis Isolated from Patients with Pulmonary Tuberculosis in the Russian Federation

Delamanid is one of the key new drugs for the treatment of multidrug-resistant and, in particular, extensively drug-resistant tuberculosis. However, due to its relatively recent introduction into clinical practice, data on the frequencу of resistance detection to this drug remain limited. The aim of the study was to determine the phenotypic susceptibility of Mycobacterium tuberculosis, isolated from patients with pulmonary tuberculosis in the Russian Federation, to delamanid. Materials and methods. The study included a total of 271 M. tuberculosis isolates with different resistance pat terns, obtained from patients in the Russian Federation (2022–2025). Resistance to delamanid (pure substance, Otsuka Pharmaceutical Co., Ltd., Japan) was determined using a modified proportional assay in the BACTEC MGIT 960 system; the critical concentration for delamanid was 0.06 µg/mL. Results. Resistance to delamanid was detected in 14.39% (39/271) of cases in both M. tuberculosis isolates susceptible to other anti-tuberculosis drugs and M. tuberculosis isolates with resistance profiles including 1 to 10 drugs (excluding delamanid). The incidence of delamanid resistance in M. tuberculosis with retained susceptibility to rifampin and in M. tuberculosis with multidrug/extensive drug resistance did not differ significantly, amounting to 11.49% and 15.76%, respectively. Primary resistance to delamanid was detected in at least 3.69% (10/271) of the cases. Conclusion. The data obtained indicate a significant level of resistance to delamanid, including among isolates not exposed to the drug. Therefore, it is imperative to improve measures to control the spread of pathogens resistant to this antimicrobial agent.

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