Case Report: Dynamics of Acquired Fluoroquinolone Resistance under Standardized Short-Course Treatment of Multidrug-Resistant Tuberculosis

We report a case of acquired fluoroquinolone (FQ) resistance under short-course multidrug-resistant tuberculosis (MDR-TB) treatment. The patient was managed at Kabutare hospital, one of the two specialized MDR-TB clinics in Rwanda. A low dose of moxifloxacin was used in the first three critical mont...

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Detalles Bibliográficos
Autores principales: Ngabonziza, Jean Claude Semuto, Van Deun, Armand, Migambi, Patrick, Niyigena, Esdras Belamo, Dusabe, Théogène, Habimana, Yves Mucyo, Ushizimpumu, Bertin, Mulders, Wim, Decroo, Tom, Affolabi, Dissou, Supply, Philip, de Jong, Bouke C., Rigouts, Leen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The American Society of Tropical Medicine and Hygiene 2020
Materias:
Articles
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7543851/
https://www.ncbi.nlm.nih.gov/pubmed/32618257
http://dx.doi.org/10.4269/ajtmh.20-0201
Descripción
Sumario:We report a case of acquired fluoroquinolone (FQ) resistance under short-course multidrug-resistant tuberculosis (MDR-TB) treatment. The patient was managed at Kabutare hospital, one of the two specialized MDR-TB clinics in Rwanda. A low dose of moxifloxacin was used in the first three critical months. Acquired resistance was identified at the ninth month of treatment, 3 months after stopping kanamycin in a strain initially susceptible only to FQs, kanamycin, and clofazimine. Fluoroquinolone resistance was detected in the same month by deep sequencing as routinely used second-line line probe assay and phenotypic drug susceptibility testing. High-dose FQ, preferably gatifloxacin, should be used to maximize effectiveness.

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