Risk factors associated with fluoroquinolone‐resistant tuberculosis in a Beijing tuberculosis referral hospital

Abstract

The rapid increase in the number of multi-drug-resistant tuberculosis (MDR-TB) cases worldwide emphasizes the importance of rational use of key important life-saving second-line anti-TB drugs such as fluoroquinolones. In order to provide information for better case management, so as to minimize the further spread of extensively drug-resistant TB, a retrospective study was performed to assess the risk factors associated with fluoroquinolone resistance among TB patients attending the 309 Hospital in Beijing, China. Drug susceptibility testing results and clinical data for hospitalized TB patients for the period 2000-2010 were analysed. Univariate and multivariate analyses were used to determine the risk factors associated with fluoroquinolone-resistant TB. From July 2000 to July 2010, ofloxacin resistance was observed in 306 of 3546 (8.6%) hospitalized TB patients who were tested. The independent risk factors associated with fluoroquinolone-resistant TB were being single (adjusted OR 1.65), being a migrant living in Beijing (adjusted OR 2.15), being a migrant from another area (adjusted OR 5.07), being a patient who was retreated (adjusted OR 2.84), exposure to fluoroquinolones (adjusted OR 2.73), having COPD (adjusted OR 3.53), having COPD with known exposure to fluoroquinolones (adjusted OR 2.47), having MDR-TB (adjusted OR 1.67), and having poly-resistant TB (adjusted OR 2.34). These findings suggest that in high-risk populations continuous surveillance of fluoroquinolone resistance should be maintained. In addition, programs should be implemented for the management of patients with MDR-TB and more complicated TB, so as to minimize the further spread of fluoroquinolone resistance and extensively drug-resistant TB.