title: Activity of twelve second-line antimicrobial agents against Mycobacterium tuberculosis in Taiwan.
abstract: Multidrug resistant (MDR) tuberculosis has emerged as a major public health problem worldwide. However, knowledge of the regional complete susceptibility to second-line drugs is rare, which impedes development of a global strategy of tuberculosis control. Presently, we determined the susceptibility of 125 isolates from southern Taiwan to 5 first-line and 12 second-line antituberculosis drugs. Except for a lower resistance to ethionamide (9.6% of isolates), more than 20% of the isolates were resistant to second-line drugs (kanamycin, 29.6%; p-aminosalicyclic acid, 71.2%; cycloserine, 24.8%; capreomycin, 24.8%; and ofloxacin, 28.5%). Twenty-two (17.6%) MDR strains displayed higher resistance to second-line antituberculous agents, compared with non-MDR strains, with markedly higher resistance rates evident for ethambutol, pyrazinamide, streptomycin, kanamycin, and ofloxacin. For clofazimine, amikacin, clarithromycin, ciprofloxacin, and amoxicillin/clavulanate, the MIC(90 )of the MDR isolates all exceeded those of non-MDR isolates. Moreover, four extensively drug resistant (XDR) strains first found in Taiwan, accounted for 3.2% of all isolates. The high resistance to the second-line drugs, especially among MDR strains, stresses the importance of proper treatment in Taiwan and threatens the global control of tuberculosis.
authors.affiliation: Department of Internal Medicine, Graduate Institute of Medicine Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: Po-Liang
authors.initials: PL
authors.lastname: Lu
authors.forename: Chien-Fang
authors.initials: CF
authors.lastname: Peng
authors.forename: Jhi-Jhih
authors.initials: JJ
authors.lastname: Hwang
authors.forename: Yen-Hsu
authors.initials: YH
authors.lastname: Chen
mesh_terms: D000617:Aminoglycosides / Q000494:pharmacology; D000995:Antitubercular Agents / Q000494:pharmacology*; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D013624:Taiwan; D018088:Tuberculosis, Multidrug-Resistant / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000382:microbiology*
chemical_list: D000617:Aminoglycosides; D000995:Antitubercular Agents