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Free Content Concomitant increases in spectrum and level of drug resistance in Mycobacterium tuberculosis isolates

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OBJECTIVE: To determine the drug resistance spectrum and resistance levels of extensively drug-resistant (XDR-) and multidrug-resistant tuberculosis (MDR-TB) and TB resistant to either rifampicin (RMP, R) or isoniazid (INH, H; R/H-DR).

DESIGN: Of 142 drug-resistant clinical isolates examined, 13 were XDR-TB, 66 were MDR-TB and 63 were R/H-DR. The drug resistance spectrum was tested by the absolute two-concentration method. Minimum inhibitory concentrations (MICs) were determined for the strains by agar dilution method on Löwenstein-Jensen slants.

RESULTS: The drug resistance spectrum of XDR-TB, MDR-TB and R/H-DR TB isolates ranged from 4 to 9, 2 to 6 and 1 to 5 drugs, respectively. Over half of all XDR-TB (53.8%), MDR-TB (66.7%) and R/H-DR (54.0%) isolates were resistant to two other anti-tuberculosis drugs; 38.5% of XDR-TB, 24.2% of MDR-TB and 28.6% of R/H-DR TB isolates were resistant to ≥3 additional anti-tuberculosis drugs in addition to those originally defined, demonstrating that the MIC values and the proportions of strains with higher MICs followed a trend of XDR-TB > MDR-TB > R/H-DR for INH, RMP, ofloxacin and ethambutol.

CONCLUSION: XDR-TB, MDR-TB and R/H-DR TB isolates exhibited both increasingly broader resistance spectra and a higher percentage of strains with high MICs to more frequently resistant drugs, which might be related to patterns of TB chemotherapy.
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Keywords: M. tuberculosis; drug resistance; resistance spectrum

Document Type: Regular Paper

Affiliations: 1: Department of Bacteriology and Immunology, Beijing Tuberculosis & Thoracic Tumour Research Institute, Beijing, China 2: Department of Functional Genomics, Qingdao Institute of Bioenergy and Bioprocess Technology, China Academy of Science, Qingdao, China 3: National Reference Laboratory for Tuberculosis, Beijing Tuberculosis & Thoracic Tumour Research Institute, Beijing, China

Publication date: 2010-11-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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