In Vitro Drug Susceptibility of Bedaquiline, Delamanid, Linezolid, Clofazimine, Moxifloxacin, and Gatifloxacin against Extensively Drug-Resistant Tuberculosis in Beijing, China

Copyright © 2017 American Society for Microbiology..

Extensively drug-resistant tuberculosis (XDR-TB) is a deadly form of TB that can be incurable due to its extreme drug resistance. In this study, we aimed to explore the in vitro susceptibility to bedaquiline (BDQ), delamanid (DMD), linezolid (LZD), clofazimine (CLO), moxifloxacin (MFX), and gatifloxacin (GAT) of 90 XDR-TB strains isolated from patients in China. We also describe the genetic characteristics of XDR-TB isolates with acquired drug resistance. Resistance to MFX, GAT, LZD, CLO, DMD, and BDQ was found in 82 (91.1%), 76 (84.4%), 5 (5.6%), 5 (5.6%), 4 (4.4%), and 3 (3.3%) isolates among the XDR-TB strains, respectively. The most frequent mutations conferring fluoroquinolone resistance occurred in codon 94 of the gyrA gene (57.8%), and the strains with these mutations (69.2%) were associated with high-level MFX resistance compared to strains with mutations in codon 90 (25.0%) (P < 0.01). All 5 CLO-resistant isolates exhibited ≥4-fold upward shifts in the BDQ MIC, which were attributed to mutations of codons 53 (60.0%) and 157 (20.0%) in the Rv0678 gene. Additionally, mutation in codon 318 of the fbiC gene was identified as the sole mutation related to DMD resistance. In conclusion, our data demonstrate that the XDR-TB strains exhibit a strikingly high proportion of resistance to the current anti-TB drugs, whereas BDQ, DMD, LZD, and CLO exhibit excellent in vitro activity against XDR-TB in the National Clinical Center on TB of China. The extensive cross-resistance between OFX and later-generation fluoroquinolones indicates that MFX and GAT may have difficulty in producing the desired effect for XDR-TB patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2017

Erschienen:

2017

Enthalten in:

Zur Gesamtaufnahme - volume:61

Enthalten in:

Antimicrobial agents and chemotherapy - 61(2017), 10 vom: 04. Okt.

Sprache:

Englisch

Beteiligte Personen:

Pang, Yu [VerfasserIn]
Zong, Zhaojing [VerfasserIn]
Huo, Fengmin [VerfasserIn]
Jing, Wei [VerfasserIn]
Ma, Yifeng [VerfasserIn]
Dong, Lingling [VerfasserIn]
Li, Yunxu [VerfasserIn]
Zhao, Liping [VerfasserIn]
Fu, Yuhong [VerfasserIn]
Huang, Hairong [VerfasserIn]

Links:

Volltext

Themen:

78846I289Y
Antitubercular Agents
Bedaquiline
Clofazimine
D959AE5USF
DNA Gyrase
Delamanid
Diarylquinolines
EC 5.99.1.3
Extensively drug-resistant tuberculosis
Fluoroquinolones
Gatifloxacin
ISQ9I6J12J
Journal Article
L4618BD7KJ
Linezolid
MIC
Minimal inhibitory concentration
Moxifloxacin
Nitroimidazoles
OPC-67683
Oxazoles
U188XYD42P

Anmerkungen:

Date Completed 30.05.2018

Date Revised 02.12.2018

published: Electronic-Print

Citation Status MEDLINE

doi:

10.1128/AAC.00900-17

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM274145898