title: Fluoroquinolone resistance in patients with newly diagnosed tuberculosis.
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.
authors: Center for Tuberculosis Research, Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors: Amy Sarah
authors: AS
authors: Ginsburg
authors: Nancy
authors: N
authors: Hooper
authors: Nikki
authors: N
authors: Parrish
authors: Kelly E
authors: KE
authors: Dooley
authors: Susan E
authors: SE
authors: Dorman
authors: Jay
authors: J
authors: Booth
authors: Marie
authors: M
authors: Diener-West
authors: William G
authors: WG
authors: Merz
authors: William R
authors: WR
authors: Bishai
authors: Timothy R
authors: TR
authors: Sterling
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology*; D015331:Cohort Studies; D024881:Drug Resistance, Bacterial / Q000502:physiology*; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D012189:Retrospective Studies; D014376:Tuberculosis / Q000382:microbiology*
chemical_list: D000995:Antitubercular Agents; D024841:Fluoroquinolones