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

Article information

Abstract

Objectives

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

Full text is only aviable in PDF

References

[1.]

A. Reid, F. Scano, H. Getahun, et al.

Towards universal access to HIV prevention, treatment, care, and support: the role of tuberculosis/HIV collaboration.

Lancet Infect Dis, 6 (2006), pp. 483-495

http://dx.doi.org/10.1016/S1473-3099(06)70549-7 | Medline

[2.]

P.R. Donald, P.D. van Helden.

The global burden of tuberculosis — combating drug resistance in difficult times.

N Engl J Med, 23 (2009), pp. 2393-2395

[3.]

C.D. Wells, J.P. Cegielski, L.J. Nelson, et al.

HIV infection and multidrug-resistant tuberculosis – the perfect storm.

JID, 196 (2007),

[4.]

W. Lew, M. Pai, O. Oxlade, et al.

Initial drug resistance and tuberculosis treatment outcomes: systematic review and meta-analysis.

Ann Intern Med, 149 (2008), pp. 123-134

Medline

[5.]

A. Faustini, A.J. Hall, C.A. Perucci.

Risk factors for multidrug resistant tuberculosis in Europe: a systematic review.

Thorax, 61 (2006), pp. 158-163

http://dx.doi.org/10.1136/thx.2005.045963 | Medline

[6.]

World Health Organization.

Global tuberculosis control: a short update to the 2009 report.

World Health Organization, (2009),

[7.]

M. Wolfart, A.L. Barth, D. Willers, et al.

Mycobacterium tuberculosis resistance in HIV-infected patients from a tertiary careteaching hospital in Porto Alegre, southern Brazil.

Trans R Soc Trop Med Hyg, 102 (2008), pp. 421-425

http://dx.doi.org/10.1016/j.trstmh.2008.02.017 | Medline

[8.]

F. Fandinho, A. Kritski, C. Hofer, et al.

Drug resistance patterns among hospitalized tuberculous patients in Rio de Janeiro, Brazil, 1993–1994.

Mem Inst Oswaldo Cruz, 94 (1999), pp. 543-547

Medline

[9.]

W.P. Pinto, D.J. Hadad, M.A. Silva Telles, et al.

Tuberculosis and drug resistance among patients seen at an AIDS reference center in Sao Paulo, Brazil.

Int J Infect Dis, 5 (2001), pp. 93-100

Medline

[10.]

K. Kliiman, A. Altraja.

Predictors of extensively drug-resistant pulmonary tuberculosis.

Ann Intern Med, 150 (2009), pp. 766-775

Medline

[11.]

L. Vashakidze, A. Salakaia, N. Shubladze, et al.

Prevalence and risk factors for drug resistance among hospitalized tuberculosis patients in Georgia.

Int J Tuberc Lung Dis, 13 (2009), pp. 1148-1153

Medline

[12.]

I.N. Park, S.B. Hong, Y.M. Oh, et al.

Impact of short-term exposure to quinolones on ofloxacin resistance in HIV-negative patients with tuberculosis.

Int J Tuberc Lung Dis, 11 (2007), pp. 319-324

Medline

[13.]

J.Y. Wang, L.N. Lee, H.C. Lai, et al.

Quinolone resistance in Mycobacterium tuberculosis isolates: associated genetic mutations and relationship to antimicrobial exposure.

JAC, 59 (2007), pp. 860-865

http://dx.doi.org/10.1093/jac/dkm061 | Medline

[14.]

R. Long, H. Chong, V. Hoeppner, et al.

Empirical treatment of community-acquired pneumonia and the development of quinolone-resistant tuberculosis.

Clin Infect Dis, 48 (2009), pp. 1354-1360

http://dx.doi.org/10.1086/598196 | Medline

Indexed in:

Follow us:

Indexed in:

Follow us:

Subscribe to our newsletter