Open AccessCase Report: Dynamics of Acquired Fluoroquinolone Resistance under Standardized Short-Course Treatment of Multidrug-Resistant Tuberculosis
Author(s) -
Jean Claude Semuto Ngabonziza,
Armand Van Deun,
Patrick Migambi,
Esdras Belamo Niyigena,
Théogène Dusabe,
Yves Mucyo Habimana,
Bertin Ushizimpumu,
Wim Mulders,
Tom Decroo,
Dissou Affolabi,
Philip Supply,
Bouke C. de Jong,
Leen Rigouts
Publication year - 2020
Publication title -
american journal of tropical medicine and hygiene
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.015
H-Index - 151
eISSN - 1476-1645
pISSN - 0002-9637
DOI - 10.4269/ajtmh.20-0201
Subject(s) - gatifloxacin , moxifloxacin , clofazimine , tuberculosis , medicine , kanamycin , multiple drug resistance , drug resistance , antibiotics , pharmacology , virology , microbiology and biotechnology , biology , immunology , levofloxacin , leprosy , pathology
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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