DOI: 10.1002/ame2.12505
Study of fluoroquinolones resistance in rifampicin-resistant tuberculosis patients in Beijing:Characteristics,trends,and treatment outcomes
Wang Nenhan
Tian Lili
Zhao Yanfeng
Chen Shuangshuang
Tao LiYing
Li Qiao
Li Chuanyou
Dai Xiaowei
Abstract：Background: China is a high-burden country for multidrug-resistant tuberculosis/rifampin-resistant tuberculosis (MDR/RR-TB). Fluoroquinolones (FQs) are key drugs for the treatment of patients with MDR/RR-TB. However, research on the resistance of FQs in Beijing is limited.
Methods: We collected clinical isolates from all patients with pulmonary TB in Beijing from January 2016 to December 2021, conducted drug-sensitivity tests and sequencing for levofloxacin (LFX) and moxifloxacin (MFX), and collected the treatment plans and outcomes of the patients.
Results: A total of 8512 clinical isolates were collected from patients with pulmonary TB, and 261 RR-TB strains were screened. The proportions of drug-sensitive and drug-resistant strains significantly differed by age group and treatment history. The rates of LFX and MFX resistance were 27.6% (72/261) and 36.4% (95/261), respectively. The detection rates of MDR-TB and pre-extensively drug-resistant TB (pre-XDR-TB) were 73.2% (191/261) and 36.4% (95/261), respectively, and the trends were significant (x2 trend=9.995, p=0.002; x2 trend=12.744, p=0.026). Among the 261 RR-TB strains, 14.9% (24/261) were sensitive to LFX but resistant to MFX. Among the four patients with LFX-resistant TB who received LFX treatment, failed in three patients (Fisher's exact test, p=0.009). The common mutation sites were 94 and 90 in gyrA. A novel mutation Ala90Ser was discovered.
Conclusions: FQs resistance trends in RR-TB patients in Beijing are striking. Strains showed incomplete cross-resistance to LFX and MFX. Testing for FQs resistance and developing a reasonable treatment plan are recommended. Attention should be given to the changing trends in MDR-TB and pre-XDR-TB.
Keywords：drug resistancelevofloxacinmoxifloxacinmycobacterium tuberculosispre-XDR-TB
Publication Date：2025-03-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：10( 906-915 )