TY - JOUR T1 - High proportion of fluoroquinolone mono-resistant <em>mycobacterium tuberculosis</em> (MTB) strains in Pakistan (2010-2012) JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P2824 AU - Kauser Jabeen AU - Faisal Malik AU - Rumina Hasan Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P2824.abstract N2 - Introduction:The prospect of using fluoroquinolones (FQ) as a first line therapy for TB has been challenged due to the concern of increased FQ resistance in countries with high FQ usage for other infections. Increased FQ resistance in multidrug resistant (MDR) MTB strains has already been reported from Pakistan. In this study we have analyzed trend of FQ resistance in non-MDR TB over a three year period (2010-2012).Methods:Study was conducted at the Aga Khan University laboratory, a technical partner of Pakistan National TB Program with periodic validation by the WHO Supra-National Reference Laboratory network. The laboratory receives specimens across the country through its peripheral collection units. MTB was isolated using standard methods. Susceptibility testing was performed using agar proportion method with drug concentrations as recommended by Clinical Laboratory Institute Standards (CLSI). FQ susceptibilities were determined using ofloxacin 2ug/ml. MDR was defined as resistance to both isoniazid (0.2 ug/ml) and rifampicin.Results:During the study period 8170 MTB strains were isolated. Of these 3321 (40.6%) were MDR and 4849 were non-MDR. In non-MDR MTB strains FQ resistance increased from 214/2059 (10.3%) in 2010 to 184/953 (19.3%) in 2012. The proportion of FQ mono-resistant TB strains in non MDR TB increased from 125/2059 (6%) in 2010 to 108/953 (11.3%) in 2012.Conclusions:Increasing trend of FQ resistance in non MDR MTB strains with high proportion of FQ mono-resistant strains in Pakistan is alarming. Our data highlight limited potential of empirical FQ usage for TB treatment in both MDR and non-MDR cases. ER -