Fluoroquinolone Resistance in Patients with Newly Diagnosed Tuberculosis

Amy Sarah Ginsburg, Nancy Hooper, Nikki Parrish, Kelly E. Dooley, Susan E. Dorman, Jay Booth, M. Diener-West, William G. Merz, William R. Bishai, Timothy R. Sterling

Research output: Contribution to journalArticlepeer-review

Abstract

Fluoroquinolones are widely used for the treatment of bacterial infections and are also second-line therapy for tuberculosis. However, fluoroquinolone resistance in patients with newly diagnosed cases of tuberculosis is not routinely assessed. We performed in vitro susceptibility testing of Mycobacterium tuberculosis to fluoroquinolones for all culture-confirmed tuberculosis cases in adults that were diagnosed at Johns Hopkins Hospital (Baltimore) between January 1998 and March 2002. Fifty-five patients were included in the study; 19 received fluoroquinolone monotherapy before the initiation of antituberculosis therapy. Two of 55 M. tuberculosis isolates (4%; 95% CI, 1%-13%) had decreased susceptibility to fluoroquinolones, including 2 of 19 of those from patients who had received fluoroquinolones (11%; 95% CI, 1%-33%) and 0 of 36 isolates from those who had not (95% CI, 0%-10%). The 2 fluoroquinolone-resistant M. tuberculosis strains were both from patients with acquired immunodeficiency syndrome and a CD4+ lymphocyte count of <50 cells/mm3. The incidence of M. tuberculosis fluoroquinolone resistance in this small sample of patients with newly diagnosed tuberculosis was high, particularly among patients with prior fluoroquinolone exposure.

Original languageEnglish (US)
Pages (from-to)1448-1452
Number of pages5
JournalClinical Infectious Diseases
Volume37
Issue number11
DOIs
StatePublished - Dec 1 2003

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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