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Volume 31, Number 3—March 2025
Research Letter

Fluoroquinolone Resistance in Drug-Resistant Tuberculosis, Kharkiv, Ukraine, 2019–2023

Olha Konstantynovska, Tetiana Synenko, Alla Honcharenko, Olha Volobuieva, Tetiana Liadova, Maja Reimann, Christoph Lange, and Dumitru ChesovComments to Author 
Author affiliation: Imperial College London, London, UK (O. Konstantynovska); Kharkiv Regional Phthisiopulmonological Center, Kharkiv, Ukraine (O. Konstantynovska, T. Synenko, A. Honcharenko, O. Volobuieva); V.N. Karazin Kharkiv National University, Kharkiv (O. Konstantynovska, O. Volobuieva, T. Liadova); Leibniz Lung Center, Borstel, Germany (M. Reimann, C. Lange, D. Chesov); German Center for Infection Research (DZIF), Hamburg-Lübeck-Borstel-Riems, Germany (M. Reimann, C. Lange, D. Chesov); University of Lübeck, Lübeck, Germany (C. Lange); Baylor College of Medicine and Texas Children's Hospital, Global Tuberculosis Program, Houston, Texas, USA (C. Lange); Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Moldova (D. Chesov)

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Table

Resistance to second-line drugs in a study of fluoroquinolone resistance in drug-resistant TB, Kharkiv, Ukraine, 2019–2023*

Category
 2014
 2019
 2020
 2021
 2022
 2023
 Kendall τ
No. patients with MDR/RR TB 169 333 231 243 155 262 0.07
New TB patients with MDR/RR TB, no. (%)
 104 (61.5)
 256 (76.9)
 178 (77.1)
 173 (71.2)
 125 (80.6)
 187 (71.4)
 0.07†
Group A drugs, % resistant
Moxifloxacin 14.9 NT 15.0 10.6 20.8 20.9 0.6
Levofloxacin 10.0 23.1 27.2 26.9 31.2 28.2 0.73
Bedaquiline NT NT 0 0 0.7 0.4 0.55
Linezolid
 2.9
 0.3
 0
 0.5
 2.7
 0.4
 −0.07
Group B drugs, % resistant
Clofazimine NT 0 0 0 0 0.4 0.63
Cycloserine
 5.8
 0
 NT
 NT
 NT
 NT
 NA
Group C drugs, % resistant
Ethambutol 66.3 75.4 60.1 37.9 49.4 54.4 −0.47
Delamanid NT 0 1.8 0.9 0.7 1.7 0.2
Pyrazinamide 69.6 54.9 54.9 54.3 55.3 58.6 0
Imipenem/meropenem NT NT NT NT NT NT NA
Amikacin 23.4 12.4 13.2 18.5 20.4 18.0 0.07
Streptomycin 95.9 75.3 78.4 NT NT NT −0.33
Ethionamide 33.6 32.7 26.1 24.4 27.3 NT −0.6
Para-aminosalicylic acid 3.1 NT NT NT NT NT NA

*Results referred to phenotypic drug susceptibility testing, performed by using the BACTEC MGIT960 culture system (Becton Dickinson, https://www.bd.com), applying World Health Organization–recommended critical concentrations. Drug groups are from the World Health Organization (3). MDR/RR, multidrug resistant/rifampin resistant; NA, not applicable; NT, not tested; TB, tuberculosis. †The Kendal τ coeficient for the trend for the percentage of new TB patients over the study period 2014 and 2019–2023 was 0.33.

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References
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