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Case Report: Dynamics of Acquired Fluoroquinolone Resistance under Standardized Short-Course Treatment of Multidrug-Resistant Tuberculosis

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Ngabonziza, Jean Claude Semuto | van Deun, Armand | Migambi, Patrick | Niyigena, Esdras Belamo | Dusabe, Théogène | Habimana, Yves Mucyo | Ushizimpumu, Bertin | Mulders, Wim | Decroo, Tom | Affolabi, Dissou | Supply, Philip | de Jong, Bouke, C. | Rigouts, Leen

Edité par CCSD ; American Society of Tropical Medicine and Hygiene -

International audience. We report a case of acquired fluoroquinolone (FQ) resistance under short-course multidrug-resistant tuberculosis (MDR-TB) treatment. The patient was managed at Kabutare hospital, one of the two specialized MDR-TB clinics in Rwanda. A low dose of moxifloxacin was used in the first three critical months. Acquired resistance was identified at the ninth month of treatment, 3 months after stopping kanamycin in a strain initially susceptible only to FQs, kanamycin, and clofazimine. Fluoroquinolone resistance was detected in the same month by deep sequencing as routinely used second-line line probe assay and phenotypic drug susceptibility testing. High-dose FQ, preferably gatifloxacin, should be used to maximize effectiveness.

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