A composite reference standard is needed for bedaquiline antimicrobial susceptibility testing for Mycobacterium tuberculosis complex.

Competing Interests: Conflicts of interest: C.U. Köser is a consultant for Becton Dickinson, the Foundation for Innovative New Diagnostics, the TB Alliance, and the WHO Regional Office for Europe; the consultancy for Becton Dickinson involves a collaboration with Janssen and Thermo Fisher Scientific. C.U. Köser is an unpaid advisor to Cepheid and GenoScreen (GenoScreen covered related travel and accommodation expenses only), has worked as a consultant for the Stop TB Partnership and the WHO Global TB Programme, has given a paid educational talk for Oxford Immunotec, has collaborated with PZA Innovation and has been an unpaid advisor to BioVersys. D.M. Cirillo is the co-chair of the Working Group of the Stop TB Partnership New Diagnostics and is an unpaid member of EUCAST subcommittee for antimicrobial susceptibility testing of mycobacteria, the CLSI M24 mycobacterial working group, and the WHO Strategic and Technical Advisory Group for diagnostics. The remaining authors have no potential conflicts of interest to disclose.