title: Emergence of fluoroquinolone-resistant tuberculosis in New York City.
abstract: 22 patients infected with fluoroquinolone-resistant Mycobacterium tuberculosis in New York City were identified between January, 1991, and November, 1993. In 16 patients resistance arose as a result of inadequate or inappropriate treatment. 6 patients had primary infection with fluoroquinolone-resistant organisms; 5 acquired the organisms nosocomially. Seven distinct patterns of restriction-fragment length polymorphism were identified in isolates from 21 patients. Fluoroquinolones should be restricted to patients with multidrug-resistant disease or intolerance to other antituberculosis drugs. All patients with multidrug-resistant tuberculosis should be on directly observed therapy.
authors.affiliation: New York City Department of Health, New York, USA.
authors.forename: E A
authors.initials: EA
authors.lastname: Sullivan
authors.forename: B N
authors.initials: BN
authors.lastname: Kreiswirth
authors.forename: L
authors.initials: L
authors.lastname: Palumbo
authors.forename: V
authors.initials: V
authors.lastname: Kapur
authors.forename: J M
authors.initials: JM
authors.lastname: Musser
authors.forename: A
authors.initials: A
authors.lastname: Ebrahimzadeh
authors.forename: T R
authors.initials: TR
authors.lastname: Frieden
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D000328:Adult; D000890:Anti-Infective Agents / Q000494:pharmacology*; D000995:Antitubercular Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D009519:New York City / Q000453:epidemiology; D012150:Polymorphism, Restriction Fragment Length; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
chemical_list: D000890:Anti-Infective Agents; D000995:Antitubercular Agents; D024841:Fluoroquinolones