Analysis of Drug Susceptibility Testing and Fluoroquinolone-Resistant Mutations in Mycobacterium tuberculosis Complex
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Fluoroquinolones (FQs) are important drugs used to treat tuberculosis (TB), particularly multidrug-resistant (MDR) TB, whose management remains challenging. Herein, we aimed to analyze the susceptibility of TB to anti-TB agents and identify gene mutations associated with FQ resistance. Between 2017 and 2022, acid-fast bacilli drug susceptibility testing (DST) was performed in 11,748 cases, whereas between 2020 and 2023, TB quinolone rapid susceptibility testing was performed in 817 cases. Our analyses revealed that 7.3 and 11.4% of cases exhibited isoniazid (INH) resistance at doses of 1.0 and 0.2 μg/ml, respectively. In comparison, rifampin (RIF) resistance was observed in 3.3 and 2.2% of cases at doses of 1.0 and 0.5 μg/ml, respectively. Quinolone resistance-determining region tests identified mutations in gyrA (2.0% in D94G and 1.2% in A90V) and gyrB (0.4% in N499T and 0.4% in D461N), which corresponded to the prevalence of MDR-TB. In this study, DST was conducted for the anti-TB drugs INH, RIF, and FQ to assess resistance patterns in Mycobacterium tuberculosis strains. Various diagnostic methods, including cell culture and DST, are needed to accurately diagnose TB and identify gene mutations associated with FQ resistance, which will help in MDR-TB treatment.
Abstract
Fluoroquinolones (FQs) are important drugs used to treat tuberculosis (TB), particularly multidrug-resistant (MDR) TB, whose management remains challenging. Herein, we aimed to analyze the susceptibility of TB to anti-TB agents and identify gene mutations associated with FQ resistance. Between 2017 and 2022, acid-fast bacilli drug susceptibility testing (DST) was performed in 11,748 cases, whereas between 2020 and 2023, TB quinolone rapid susceptibility testing was performed in 817 cases. Our analyses revealed that 7.3 and 11.4% of cases exhibited isoniazid (INH) resistance at doses of 1.0 and 0.2 μg/ml, respectively. In comparison, rifampin (RIF) resistance was observed in 3.3 and 2.2% of cases at doses of 1.0 and 0.5 μg/ml, respectively. Quinolone resistance-determining region tests identified mutations in gyrA (2.0% in D94G and 1.2% in A90V) and gyrB (0.4% in N499T and 0.4% in D461N), which corresponded to the prevalence of MDR-TB. In this study, DST was conducted for the anti-TB drugs INH, RIF, and FQ to assess resistance patterns in Mycobacterium tuberculosis strains. Various diagnostic methods, including cell culture and DST, are needed to accurately diagnose TB and identify gene mutations associated with FQ resistance, which will help in MDR-TB treatment.
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