{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T23:49:58Z","timestamp":1782949798811,"version":"3.54.5"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T00:00:00Z","timestamp":1545091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Swedish Heart Lung Foundation","award":["20150508"],"award-info":[{"award-number":["20150508"]}]},{"name":"Swedish National Research Council","award":["540-2013-8797"],"award-info":[{"award-number":["540-2013-8797"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Minimum inhibitory concentration (MIC) testing, unlike routine drug susceptibility testing (DST) at a single critical concentration, quantifies drug resistance. The association of MICs and treatment outcome in multidrug-resistant (MDR)\u2013tuberculosis patients is unclear. Therefore, we correlated MICs of first- and second-line tuberculosis drugs with time to sputum culture conversion (tSCC) and treatment outcome in MDR-tuberculosis patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical and demographic data of MDR-tuberculosis patients in Sweden, including DST results, were retrieved from medical records from 1992 to 2014. MIC determinations were performed retrospectively for the stored individual Mycobacterium tuberculosis (Mtb) isolates using broth microdilution in Middlebrook 7H9. We fitted Cox proportional hazard models correlating MICs, DST results, and clinical variables to tSCC and treatment outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Successful treatment outcome was observed in 83.5% (132\/158) of MDR-tuberculosis patients. Increasing MICs of fluoroquinolones, diabetes, and age &gt;40 years were significantly associated with unsuccessful treatment outcome. Patients treated with pyrazinamide (PZA) had a significantly shorter tSCC compared to patients who were not (median difference, 27 days).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Increasing MICs of fluoroquinolones were correlated with unsuccessful treatment outcome in MDR-tuberculosis patients. Further studies, including MIC testing and clinical outcome data to define clinical Mtb breakpoints, are warranted. PZA treatment was associated with shorter tSCC, highlighting the importance of PZA DST.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciy1068","type":"journal-article","created":{"date-parts":[[2018,12,13]],"date-time":"2018-12-13T17:47:50Z","timestamp":1544723270000},"page":"1394-1402","source":"Crossref","is-referenced-by-count":11,"title":["Minimum Inhibitory Concentrations of Fluoroquinolones and Pyrazinamide Susceptibility Correlate to Clinical Improvement in Multidrug-resistant Tuberculosis Patients: A Nationwide Swedish Cohort Study Over 2 Decades"],"prefix":"10.1093","volume":"69","author":[{"given":"Lina Davies","family":"Forsman","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Infectious Diseases, Karolinska University Hospital Solna, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerker","family":"Jonsson","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Public Health Analysis and Data Management, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotta","family":"Wagrell","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim","family":"Werngren","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Public Health Agency of Sweden, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Mansj\u00f6","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Public Health Agency of Sweden, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Wijkander","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Public Health Agency of Sweden, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramona","family":"Groenheit","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Public Health Agency of Sweden, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Hammar","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian G","family":"Giske","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Sch\u00f6n","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Link\u00f6ping University, Sweden"},{"name":"Department of Clinical Microbiology and Infectious Diseases, Kalmar County Hospital, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Bruchfeld","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Infectious Diseases, Karolinska University Hospital Solna, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,12,18]]},"reference":[{"key":"2019092701015822200_CIT0001","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1016\/S1473-3099(17)30247-5","article-title":"Estimating the future burden of 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