FACTORS ASSOCIATED WITH ACQUIRED FLUOROQUINOLONE RESISTANCE IN MYCOBACTERIUM TUBERCULOSIS IN THE NOVOSIBIRSK REGION

Abstract

A retrospective cohort study was performed to reveal risk factors for fluoroquinolone resistance in M. tuberculosis during treatment of 463 patients with multidrug-resistant (MDR) tuberculosis (TB) in the Novosibirsk Region. The factors associated with an increased risk were the extent of a TB process within > 2 lung segments (OR 1.39; 95% CI, 0.87-2.21), abundant bacterial excretion (OR 2.32; 95% CI, 1.54-3.5), primary aminoglycoside/capreomycin resistance in M. tuberculosis (OR 3.35; 95% CI, 1.80-6.24), concomitant alcohol/drug dependence (OR 1.46; 95 CI, 0.76-2.80), renal dysfunction (OR 4.60; 95% CI, 1.28-16.51), deviations from the standard polychemotherapy of MDR TB (OR 3.17; 95% CI, 1.58-6.34), fluoroquinolones used in doses lower than the recommended one (OR 5.23; 95% CI, 2.27-12.10), discontinuation of a polychemotherapy cycle (OR 5.70; 95% CI, 2.97-10.93), rural residence (OR 2.0; 95% CI: 1.14-3.51), and being in prison (OR 2.0; 95% CI, 1.14-3.51). Resection surgery (OR 0.48; 95% CI, 0.2-1.13), in-hospital intensive-phase polychemotherapy (OR 0.43; 95 CI, 0.27-0.63), and parenteral administration of anti-TB drugs (OR 0.40; 95% CI, 0.18-0.86) were associated with risk reduction.