Skip Navigation


JAC Advance Access originally published online on April 5, 2007
Journal of Antimicrobial Chemotherapy 2007 59(5):860-865; doi:10.1093/jac/dkm061
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
59/5/860    most recent
dkm061v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Wang, J.-Y.
Right arrow Articles by Yang, P.-C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wang, J.-Y.
Right arrow Articles by Yang, P.-C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Fluoroquinolone resistance in Mycobacterium tuberculosis isolates: associated genetic mutations and relationship to antimicrobial exposure

Jann-Yuan Wang1, Li-Na Lee1,2, Hsin-Chih Lai3, Shu-Kuan Wang2, I-Shiow Jan2, Chong-Jen Yu1, Po-Ren Hsueh1,2,* and Pan-Chyr Yang1

1 Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan 2 Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan 3 Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan

Received 30 November 2006; returned 20 December 2006; revised 31 January 2007; accepted 5 February 2007

* Corresponding author. Tel: +886-2-23123456 ext. 5355; Fax: +886-2-23224263; E-mail: hsporen{at}ha.mc.ntu.edu.tw

Objectives: We assessed the fluoroquinolone (FQ) susceptibility of clinical isolates of Mycobacterium tuberculosis in an endemic area. The genetic mutations responsible for FQ resistance were also evaluated.

Methods: A total of 420 M. tuberculosis isolates during January 2004 to December 2005 were randomly selected. Data on the clinical characteristics of the patients were obtained from medical records. The MICs of ofloxacin, ciprofloxacin, levofloxacin and moxifloxacin were determined. Spoligotyping and sequencing of the gyrA and gyrB genes were performed for all isolates resistant to any tested FQ.

Results: Of the 420 isolates, 52 (12.4%), 26 (6.2%), 26 (6.2%) and 30 (7.1%) were resistant to isoniazid, rifampicin, ethambutol and streptomycin, respectively. Multidrug resistance was found in 5.0% of isolates. For all tested FQs, the susceptibility rate was higher than 97%. Resistance to any first-line drug and isolation from a patient with prior anti-tuberculous treatment were correlated with FQ resistance. Multidrug resistance had the strongest correlation with FQ resistance (19% of isolates). Neither the previous use of FQs nor the duration of FQ exposure was correlated with the FQ susceptibility. Of the 14 FQ-resistant isolates, five (35.7%) had gyrA mutations (four D94G and one A90V) and another one (7.1%) had a gyrB mutation (N538D).

Conclusions: This study found FQ resistance in 3.3% of all clinical isolates of M. tuberculosis. FQ resistance was correlated with first-line drug resistance and prior anti-tuberculous treatment, suggesting the need for routine FQ susceptibility testing in patients with these characteristics.

Keywords: M. tuberculosis , TB, multidrug resistance , gyrA , gyrB


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Am. J. Respir. Crit. Care Med.Home page
R. A. Devasia, A. Blackman, T. Gebretsadik, M. Griffin, A. Shintani, C. May, T. Smith, N. Hooper, F. Maruri, J. Warkentin, et al.
Fluoroquinolone Resistance in Mycobacterium tuberculosis: The Effect of Duration and Timing of Fluoroquinolone Exposure
Am. J. Respir. Crit. Care Med., August 15, 2009; 180(4): 365 - 370.
[Abstract] [Full Text] [PDF]

Home page
 Antimicrob. Agents Chemother.Home page
S. Feuerriegel, H. S. Cox, N. Zarkua, H. A. Karimovich, K. Braker, S. Rusch-Gerdes, and S. Niemann
Sequence Analyses of Just Four Genes To Detect Extensively Drug-Resistant Mycobacterium tuberculosis Strains in Multidrug-Resistant Tuberculosis Patients Undergoing Treatment
Antimicrob. Agents Chemother., August 1, 2009; 53(8): 3353 - 3356.
[Abstract] [Full Text] [PDF]

Home page
 Antimicrob. Agents Chemother.Home page
P. Xu, X. Li, M. Zhao, X. Gui, K. DeRiemer, S. Gagneux, J. Mei, and Q. Gao
Prevalence of Fluoroquinolone Resistance among Tuberculosis Patients in Shanghai, China
Antimicrob. Agents Chemother., July 1, 2009; 53(7): 3170 - 3172.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Microbiol.Home page
A. Y. Coban, K. Bilgin, M. Uzun, A. Akgunes, A. Yusof, and B. Durupinar
Comparative Study for Determination of Mycobacterium tuberculosis Susceptibility to First- and Second-Line Antituberculosis Drugs by the Etest Using 7H11, Blood, and Chocolate Agar
J. Clin. Microbiol., December 1, 2008; 46(12): 4095 - 4098.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
C. D. Mitnick, S. S. Shin, K. J. Seung, M. L. Rich, S. S. Atwood, J. J. Furin, G. M. Fitzmaurice, F. A. Alcantara Viru, S. C. Appleton, J. N. Bayona, et al.
Comprehensive Treatment of Extensively Drug-Resistant Tuberculosis
N. Engl. J. Med., August 7, 2008; 359(6): 563 - 574.
[Abstract] [Full Text] [PDF]

Home page
 Antimicrob. Agents Chemother.Home page
I. Mokrousov, T. Otten, O. Manicheva, Y. Potapova, B. Vishnevsky, O. Narvskaya, and N. Rastogi
Molecular Characterization of Ofloxacin-Resistant Mycobacterium tuberculosis Strains from Russia
Antimicrob. Agents Chemother., August 1, 2008; 52(8): 2937 - 2939.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
W. W. Yew and C. C. Leung
Update in Tuberculosis 2007
Am. J. Respir. Crit. Care Med., March 1, 2008; 177(5): 479 - 485.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.