First 2 Extensively Drug-Resistant Tuberculosis Cases From Myanmar Treated With Bedaquiline

To the Editor—Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) have been major global health crises. Myanmar is one of 14 countries that are present in all 3 of the World Health Organization's lists for high burden of TB, TB and human immunodeficiency virus (HIV), and MDR-TB [1]. Consequently, the Myanmar National TB Programme (NTP) has been collaborating with local governments as well as international organizations to intensify their efforts to combat drug-resistant TB. One of the prime examples was a recent collaborative program between Myanmar NTP and Médecins Sans Frontières called EndTB program for the treatment of critically ill MDR- and XDR-TB patients with bedaquiline, the first new TB drug for half a century, or delamanid [2]. Here, we report the first 2 XDR-TB cases in Myanmar that were confirmed by both whole-genome sequencing (WGS) and phenotypic drug susceptibility testing (DST), and consequently enrolled in the regimen consisting of bedaquiline through the EndTB program. Ethical approval for this study was given by the Ethics Review Committee of Department of Medical Research, Yangon, Myanmar.

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