Table 2.
Studies reporting prevalence of FQ resistance in non-MDR TBa
| Study (reference) | Site | Population | Finding(s) | Mutations |
|---|---|---|---|---|
| Riantawan et al. (67) | Thailand | Cardiothoracic center | Initial resistance to OFX in 1.1% of 1,738 new cases of pulmonary TB; acquired resistance to OFX in 8.1% of 123 previously treated patients | Not studied |
| Casal et al. (13) | Spain | Hospital strains | 213 strains susceptible and resistant to other drugs; OFX MIC, 1 μg/ml in 22% and 2 μg/ml in 6.1% | Not studied |
| Hemvani et al. (37) | Central India | Hospital lab isolates | 1,426 strains; Cipr, 3.6% | Not studied |
| Grimaldo et al. (34) | Makati City, Philippines | Hospital isolates | FQR with no other resistance, 1989-1994, Cipr/Ofxr, 1%/0%; 1995-2000, Cipr/Ofxr, 17.4%/24.4%; FQR and MDR, 1989-1994, Cipr/Ofxr, 10.3%/24%; 1995-2000, 51.4% both | Not studied |
| Ginsburg et al. (30) | Baltimore, MD | Newly diagnosed TB patients | FQR without FQ in previous 6 mo, 0/36; FQR with FQ, 2/19 (both AIDS patients with CD4 count <50; (i) patient 1, 6 days LVX + 7 days CIP; (ii) patient 2, 3 courses of GAT) | (i) Patient 1, resistant to all FQs, GyrA G88C; (ii) patient 2, intermediate resistance (not studied) |
| Bozeman et al. (11) | United States | Trial strains (Rifs); strains referred to CDC | From TB trials, 2/1,373 Cipr; CDC: 1996-2000, 33/1,852 (1.8%) Cipr, 25/33 (75.8%) in MDR | 26/30 had GyrA substitutions and 4/30 had no GyrA substitutions |
| Huang et al. (40) | Taiwan | Tertiary hospital, 1995-2003 | FQR in pan-sensitive strains, 1995-2003, <2%; in MDR 1995-1997, 8%; in MDR 1998-2003, 20% | Of 10 FQR, 1 A90V, 3 D94G, 1 G88A D94Y, 5 GyrA WT, all GyrB WT |
| Wang et al. (88) | Taiwan | Newly diagnosed TB patients | 9 patients with isolates before and after FQ; 1 developed resistance to OFX | Not studied |
| Park et al. (60) | Seoul, South Korea | From records of hospital microbiology | FQ exposed: Ofxr in 1/39, but primary MDR TB; Ofxr in 1.1% of newly diagnosed patients and 8.5% in patients retreated | Not studied |
| Umubyeyi et al. (81) | Rwanda | Resistance survey | In 616 new cases, 1 Ofxr and received <14 days FQ for respiratory symptoms; in 32 MDR, 3 Ofxr and all received CIP as prior TB treatment | 1 GyrA D94A, 3 GyrA T80A |
| Wang et al. (89) | Taiwan | Randomly selected isolates from tertiary facility | 420 isolates, 14 FQR (3.3%), no statistical association with previous FQ; statistical association with previous TB treatment and any other drug resistance; 28 FQS strains, no mutations | 14 FQR: GyrA, 4 D94G, 1 A90V; GyrB, 1 N538D; 8 WT GyrAB (lower avg. MICs) |
| Agrawal et al. (2) | Mumbai, India | Tertiary facility strains with DST requested | 1995-2004, MDR increased from 32% to 56%; Cipr (8 μg/ml) increased from 0% to 35% | Not studied |
| Devasia et al. (20) | Tennessee | TB patients covered by drug benefit plan | 37% had FQ: <10 days, FQR in 1/62; with FQ >10 days, FQR in 7/54 (13%); most had FQR when FQ given >60 days before TB diagnosis | Not studied |
| Long et al. (50) | Canada | TB patients covered by drug benefit plan | 428 patients, 54 with single FQ prescription, no FQR; 20 patients with multiple FQ prescriptions, 3 FQR | 1 GyrA A90V, 2 WT GyrA; CIP MIC, ≥4; all GyrB WT |
| Xu et al. (92) | Shanghai, China | TB reference lab | FQR in 1.9% in pan-sensitive, statistical association with FQR with resistance to 1st-line drugs and prior TB treatment | gyrA mutations in 81.5% of Ofxr strains; mutations not specified |
| Soudani et al. (73) | Tunisia | University hospital, all isolates 2005-2008 | Cipr (MIC, 2 or 4 μg/ml) in 4/495 isolates (0.8%); 3 new cases, 1 previously treated MDR | 1 GyrA I92M, 1 A90L; 2 WT GyrA; all GyrB WT |
| Jeon et al. (42) | South Africa | Gold miners | 440 TB patients with FQ <1 yr prior to TB diagnosis, most 1 day of FQ; only looked for gyrA mutations; 1 with GyrA change | 1 GyrA A90V in patient with multiple FQ use for a total of 8 days |
| Hu et al. (39) | Rural east China | Pulmonary TB registered patients | FQR in 31/351 strains, statistical association of FQR with treatment of respiratory illness, borderline with Beijing genotype; no statistical association with other drug resistance | 17/31 with GyrA substitutions, 3 with 2; 1 in GyrB, WT GyrA = lower FQ MICs |
| van den Boogaard et al. (83) | Tanzania | Culture-positive TB patients | 291 cultures; no resistance in 22 with FQ in previous 6 mo; 2 FQR isolates in non-FQ-exposed patients | 1 Cipr, MOX intermediate, GyrA A90V; 1 CIP intermediate, Moxs, GyrA WT |
a
WT, wild type (no mutations); FQS, FQ sensitive; FQR, FQ resistant; DST, drug sensitivity testing.