Study of fluoroquinolones resistance in rifampicin‐resistant tuberculosis patients in Beijing: Characteristics, trends, and treatment outcomes

Abstract Background China is a high‐burden country for multidrug‐resistant tuberculosis/rifampin‐resistant tuberculosis (MDR/RR‐TB). Fluoroquinolones (FQs) are key drugs for the treatment of patients with MDR/RR‐TB. However, research on the resistance of FQs in Beijing is limited. Methods We collect...

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Main Authors: Wang Nenhan, Tian Lili, Zhao Yanfeng, Chen Shuangshuang, Tao LiYing, Li Qiao, Li Chuanyou, Dai Xiaowei
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Animal Models and Experimental Medicine
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Online Access:https://doi.org/10.1002/ame2.12505
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author Wang Nenhan
Tian Lili
Zhao Yanfeng
Chen Shuangshuang
Tao LiYing
Li Qiao
Li Chuanyou
Dai Xiaowei
author_facet Wang Nenhan
Tian Lili
Zhao Yanfeng
Chen Shuangshuang
Tao LiYing
Li Qiao
Li Chuanyou
Dai Xiaowei
author_sort Wang Nenhan
collection DOAJ
description Abstract Background China is a high‐burden country for multidrug‐resistant tuberculosis/rifampin‐resistant tuberculosis (MDR/RR‐TB). Fluoroquinolones (FQs) are key drugs for the treatment of patients with MDR/RR‐TB. However, research on the resistance of FQs in Beijing is limited. Methods We collected clinical isolates from all patients with pulmonary TB in Beijing from January 2016 to December 2021, conducted drug‐sensitivity tests and sequencing for levofloxacin (LFX) and moxifloxacin (MFX), and collected the treatment plans and outcomes of the patients. Results A total of 8512 clinical isolates were collected from patients with pulmonary TB, and 261 RR‐TB strains were screened. The proportions of drug‐sensitive and drug‐resistant strains significantly differed by age group and treatment history. The rates of LFX and MFX resistance were 27.6% (72/261) and 36.4% (95/261), respectively. The detection rates of MDR‐TB and pre‐extensively drug‐resistant TB (pre‐XDR‐TB) were 73.2% (191/261) and 36.4% (95/261), respectively, and the trends were significant (χ2 trend = 9.995, p = 0.002; χ2 trend = 12.744, p = 0.026). Among the 261 RR‐TB strains, 14.9% (24/261) were sensitive to LFX but resistant to MFX. Among the four patients with LFX‐resistant TB who received LFX treatment failed in three patients(Fisher's exact test, p = 0.009). The common mutation sites were 94 and 90 in gyrA. A novel mutation Ala90Ser was discovered. Conclusions FQs resistance trends in RR‐TB patients in Beijing are striking. Strains showed incomplete cross‐resistance to LFX and MFX. Testing for FQs resistance and developing a reasonable treatment plan are recommended. Attention should be given to the changing trends in MDR‐TB and pre‐XDR‐TB.
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spelling doaj-art-e2223ccfa4e24b05a2ad6dc65399b8162025-08-20T02:29:18ZengWileyAnimal Models and Experimental Medicine2576-20952025-05-018590691510.1002/ame2.12505Study of fluoroquinolones resistance in rifampicin‐resistant tuberculosis patients in Beijing: Characteristics, trends, and treatment outcomesWang Nenhan0Tian Lili1Zhao Yanfeng2Chen Shuangshuang3Tao LiYing4Li Qiao5Li Chuanyou6Dai Xiaowei7Beijing Center for Disease Prevention and Control Beijing People's Republic of ChinaBeijing Center for Disease Prevention and Control Beijing People's Republic of ChinaBeijing Center for Disease Prevention and Control Beijing People's Republic of ChinaBeijing Center for Disease Prevention and Control Beijing People's Republic of ChinaBeijing Center for Disease Prevention and Control Beijing People's Republic of ChinaInstitute of Pathogen Biology Chinese Academy of Medical Sciences Beijing People's Republic of ChinaBeijing Center for Disease Prevention and Control Beijing People's Republic of ChinaBeijing Center for Disease Prevention and Control Beijing People's Republic of ChinaAbstract Background China is a high‐burden country for multidrug‐resistant tuberculosis/rifampin‐resistant tuberculosis (MDR/RR‐TB). Fluoroquinolones (FQs) are key drugs for the treatment of patients with MDR/RR‐TB. However, research on the resistance of FQs in Beijing is limited. Methods We collected clinical isolates from all patients with pulmonary TB in Beijing from January 2016 to December 2021, conducted drug‐sensitivity tests and sequencing for levofloxacin (LFX) and moxifloxacin (MFX), and collected the treatment plans and outcomes of the patients. Results A total of 8512 clinical isolates were collected from patients with pulmonary TB, and 261 RR‐TB strains were screened. The proportions of drug‐sensitive and drug‐resistant strains significantly differed by age group and treatment history. The rates of LFX and MFX resistance were 27.6% (72/261) and 36.4% (95/261), respectively. The detection rates of MDR‐TB and pre‐extensively drug‐resistant TB (pre‐XDR‐TB) were 73.2% (191/261) and 36.4% (95/261), respectively, and the trends were significant (χ2 trend = 9.995, p = 0.002; χ2 trend = 12.744, p = 0.026). Among the 261 RR‐TB strains, 14.9% (24/261) were sensitive to LFX but resistant to MFX. Among the four patients with LFX‐resistant TB who received LFX treatment failed in three patients(Fisher's exact test, p = 0.009). The common mutation sites were 94 and 90 in gyrA. A novel mutation Ala90Ser was discovered. Conclusions FQs resistance trends in RR‐TB patients in Beijing are striking. Strains showed incomplete cross‐resistance to LFX and MFX. Testing for FQs resistance and developing a reasonable treatment plan are recommended. Attention should be given to the changing trends in MDR‐TB and pre‐XDR‐TB.https://doi.org/10.1002/ame2.12505drug resistancelevofloxacinmoxifloxacinmycobacterium tuberculosispre‐XDR‐TB
spellingShingle Wang Nenhan
Tian Lili
Zhao Yanfeng
Chen Shuangshuang
Tao LiYing
Li Qiao
Li Chuanyou
Dai Xiaowei
Study of fluoroquinolones resistance in rifampicin‐resistant tuberculosis patients in Beijing: Characteristics, trends, and treatment outcomes
Animal Models and Experimental Medicine
drug resistance
levofloxacin
moxifloxacin
mycobacterium tuberculosis
pre‐XDR‐TB
title Study of fluoroquinolones resistance in rifampicin‐resistant tuberculosis patients in Beijing: Characteristics, trends, and treatment outcomes
title_full Study of fluoroquinolones resistance in rifampicin‐resistant tuberculosis patients in Beijing: Characteristics, trends, and treatment outcomes
title_fullStr Study of fluoroquinolones resistance in rifampicin‐resistant tuberculosis patients in Beijing: Characteristics, trends, and treatment outcomes
title_full_unstemmed Study of fluoroquinolones resistance in rifampicin‐resistant tuberculosis patients in Beijing: Characteristics, trends, and treatment outcomes
title_short Study of fluoroquinolones resistance in rifampicin‐resistant tuberculosis patients in Beijing: Characteristics, trends, and treatment outcomes
title_sort study of fluoroquinolones resistance in rifampicin resistant tuberculosis patients in beijing characteristics trends and treatment outcomes
topic drug resistance
levofloxacin
moxifloxacin
mycobacterium tuberculosis
pre‐XDR‐TB
url https://doi.org/10.1002/ame2.12505
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