Previous use of quinolones: A surrogate marker for first line anti-tuberculosis drugs resistance in HIV-infected patients?

Deutschendorf, Caroline; Goldani, Luciano Z.; Pires dos Santos, Rodrigo

doi:10.1016/S1413-8670(12)70295-7

The Brazilian Journal of Infectious Diseases

ISSN: 1413-8670

The Brazilian Journal of Infectious Diseases is the official publication of the Brazilian Society of Infectious Diseases (SBI). It aims to publish relevant articles in the broadest sense on all aspects of microbiology, infectious diseases and immune response to infectious agents.
The BJID is a bimonthly publication and one of the most influential journals in its field in Brazil and Latin America with a high impact factor. Since its inception it has garnered a growing share of the publishing market.

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Drug resistant Mycobacterium tuberculosis causes much higher rates of treatment toxicity, failure or relapse, and mortality. We determined the drug resistant profile of Mycobacterium tuberculosis strains isolated from a population of HIV-infected patients in southern Brazil and studied the potential factors associated with resistance.

Methods

We conducted a retrospective cohort study to determine the resistance profile of Mycobacterium tuberculosis isolated from HIV-infected patients and factors that could be associated with resistance from 2000 to 2005.

Results

236 patients were included in the study. Resistance to at least one drug was observed in 32 (14.6%) isolates, and multi-drug resistance was observed in 4 (1.82%) isolates. On multivariate analysis, previous use of tuberculostatics and quinolones were related to any first-line drug resistance.

Conclusions

In our study, previous quinolone use was significantly associated to first-line anti-TB drugs resistance. Multi-drug-resistant tuberculosis (MDR-TB) is a major problem worldwide, and we believe quinolones should be used with caution in settings where TB is endemic.

Keywords:

Mycobacterium tuberculosis

HIV

Quinolones

Drug resistance

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