ArticleThe Journal of antimicrobial chemotherapy2016
Specific gyrA gene mutations predict poor treatment outcome in MDR-TB.
Article in The Journal of antimicrobial chemotherapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.
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Who cites it
45 citing papers in PubMed, 95 citations in OpenAlex.
- Clinical and bacterial determinants of unfavorable tuberculosis treatment outcomes: an observational study in Georgia.Genome medicine · 2025Observational
- Fluoroquinolone and Second-Line Injectable Resistance Among Rifampicin- and Isoniazid-ResistantMicroorganisms · 2025Article
- Gatifloxacin detection in the nanoscale: a review exploring current biosensing technologies and future opportunities.RSC advances · 2025Review
- Factors associated with unfavourable treatment outcomes among patients with Multidrug-resistant Tuberculosis receiving outpatients care.Scientific reports · 2025Article
- Ciprofloxacin-driven purifying selection on viral genomes accelerates soil NProceedings of the National Academy of Sciences of the United States of America · 2025Article
- Risk assessment and transmission of fluoroquinolone resistance in drug-resistant pulmonary tuberculosis: a retrospective genomic epidemiology study.Scientific reports · 2024Article
- Identification of novel resistance-associated mutations and discrimination within whole-genome sequences of fluoroquinolone-resistantMicrobiology spectrum · 2024Article
- Distribution of common and rare drug resistance patterns inJournal of thoracic disease · 2023Article
- Rapid detection of fluoroquinolone resistance in Mycobacterium tuberculosis using a novel multienzyme isothermal rapid assay.The Journal of antibiotics · 2023Article
- Comparative Genomic Analysis of Multi-Drug ResistantMicroorganisms · 2023Article
- Clinical implications of molecular drug resistance testing for Mycobacterium tuberculosis: a 2023 TBnet/RESIST-TB consensus statement.The Lancet. Infectious diseases · 2023Review
- Article
- Clinical standards for the dosing and management of TB drugs.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Article
- Ancient and recent differences in the intrinsic susceptibility of Mycobacterium tuberculosis complex to pretomanid.The Journal of antimicrobial chemotherapy · 2022Article
- Updating the approaches to define susceptibility and resistance to anti-tuberculosis agents: implications for diagnosis and treatment.The European respiratory journal · 2022Article
- Resistance-Conferring Mutations on Whole-Genome Sequencing of Fluoroquinolone-resistant and -Susceptible Mycobacterium tuberculosis Isolates: A Proposed Threshold for Identifying Resistance.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Increasing prevalence of resistance to second-line drugs among multidrug-resistant Mycobacterium tuberculosis isolates in Kuwait.Scientific reports · 2021Article
- Xpert MTB/XDR: a 10-Color Reflex Assay Suitable for Point-of-Care Settings To Detect Isoniazid, Fluoroquinolone, and Second-Line-Injectable-Drug Resistance Directly from Mycobacterium tuberculosis-Positive Sputum.Journal of clinical microbiology · 2021Article
- Drug resistance gene mutations and treatment outcomes in MDR-TB: A prospective study in Eastern China.PLoS neglected tropical diseases · 2021Article
- Clinical Impact of Rapid Drug Susceptibility Testing to Accompany Fluoroquinolone-Containing Universal Tuberculosis Regimens: A Markov Model.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMutations in the gyrase genes cause fluoroquinolone resistance in Mycobacterium tuberculosis. However, the predictive value of these markers for clinical outcomes in patients with MDR-TB is unknown to date. The objective of this study was to determine molecular markers and breakpoints predicting second-line treatment outcomes in M. tuberculosis patients treated with fourth-generation fluoroquinolones.
methodsWe analysed treatment outcome data in relation to the gyrA and gyrB sequences and MICs of ofloxacin, gatifloxacin and moxifloxacin for pretreatment M. tuberculosis isolates from 181 MDR-TB patients in Bangladesh whose isolates were susceptible to injectable drugs.
resultsThe gyrA 90Val, 94Gly and 94Ala mutations were most frequent, with the highest resistance levels for 94Gly mutants. Increased pretreatment resistance levels (>2 mg/L), related to specific mutations, were associated with lower cure percentages, with no cure in patients whose isolates were resistant to gatifloxacin at 4 mg/L. Any gyrA 94 mutation, except 94Ala, predicted a significantly lower proportion of cure compared with all other gyrA mutations taken together (all non-94 mutants + 94Ala) [OR = 4.3 (95% CI 1.4-13.0)]. The difference in treatment outcome was not explained by resistance to the other drugs.
conclusionsOur study suggests that gyrA mutations at position 94, other than Ala, predict high-level resistance to gatifloxacin and moxifloxacin, as well as poor treatment outcome, in MDR-TB patients in whom an injectable agent is still effective.
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