Phenotypic and Molecular Genetic Resistance of Mycobacterium tuberculosis to Fluoroquinolones: A Literature Review
https://doi.org/10.58838/2075-1230-2026-104-3-107-117
Abstract
Fluoroquinolones are essential drugs for the treatment of drug-resistant tuberculosis; however, the rise in resistance to these agents significantly reduces treatment efficacy. This review summarizes current data on the molecular genetic and phenotypic mechanisms of Mycobacterium tuberculosis resistance to fluoroquinolones. Particular attention is focused on mutations in the gyrA and gyrB genes encoding DNA gyrase, the primary target of fluoroquinolones. Mutations within the QRDR of gyrA are the major determinants of resistance and are associated with an increase in the minimum inhibitory concentrations of fluoroquinolones. This review examines the role of alternative resistance mechanisms, including efflux pump systems and glpK-associated adaptations, as well as the importance of the WHO Catalogue of Mutations for variant interpretation. The integration of phenotypic and molecular diagnostic approaches is essential for the effective detection and control of drug-resistant tuberculosis.
About the Authors
I. K. Oleynik
National Medical Research Center of Phthisiopulmonology and Infectious Diseases of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Irina K. Oleynik, Junior Researcher of Microbiology Research Laboratory
4, Bldg. 2, Dostoevskogo St., Moscow, 127473;
Tel.: +7 (495) 631-15-15
P. I. Eliseev
National Medical Research Center of Phthisiopulmonology and Infectious Diseases of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Platon I. Eliseev, Candidate of Medical Sciences, Head of the Microbiology Research Laboratory
4, Bldg. 2, Dostoevskogo St., Moscow, 127473;
Tel.: +7 (495) 631-15-15
A. E. Panova
National Medical Research Center of Phthisiopulmonology and Infectious Diseases of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Anna E. Panova, Candidate of Medical Sciences, Head of the Microbiology and Molecular Genetics Research Department
4, Bldg. 2, Dostoevskogo St., Moscow, 127473;
Tel.: +7 (495) 631-15-15
A. G. Samoilova
National Medical Research Center of Phthisiopulmonology and Infectious Diseases of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Anastasia G. Samoilova, Doctor of Medical Sciences, Deputy Director for Research
4, Bldg. 2, Dostoevskogo St., Moscow, 127473;
Tel.: +7 (495) 631-15-15
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For citations:
Oleynik I.K., Eliseev P.I., Panova A.E., Samoilova A.G. Phenotypic and Molecular Genetic Resistance of Mycobacterium tuberculosis to Fluoroquinolones: A Literature Review. Tuberculosis and Lung Diseases. 2026;104(3):107-117. (In Russ.) https://doi.org/10.58838/2075-1230-2026-104-3-107-117
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