{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T01:27:12Z","timestamp":1783387632544,"version":"3.54.6"},"reference-count":43,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Key Research and Development Project of Hainan Province","award":["ZDYF2022SHFZ100"],"award-info":[{"award-number":["ZDYF2022SHFZ100"]}]},{"name":"Key Research and Development Project of Hainan Province","award":["2024MSXM043"],"award-info":[{"award-number":["2024MSXM043"]}]},{"name":"Key Research and Development Project of Hainan Province","award":["2023MSXM107"],"award-info":[{"award-number":["2023MSXM107"]}]},{"name":"Key Research and Development Project of Hainan Province","award":["2025WSJK096"],"award-info":[{"award-number":["2025WSJK096"]}]},{"name":"Key Research and Development Project of Hainan Province","award":["CSTB2024NSCQ-MSX0703"],"award-info":[{"award-number":["CSTB2024NSCQ-MSX0703"]}]},{"name":"Chongqing Medical Scientific Research Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau)","award":["ZDYF2022SHFZ100"],"award-info":[{"award-number":["ZDYF2022SHFZ100"]}]},{"name":"Chongqing Medical Scientific Research Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau)","award":["2024MSXM043"],"award-info":[{"award-number":["2024MSXM043"]}]},{"name":"Chongqing Medical Scientific Research Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau)","award":["2023MSXM107"],"award-info":[{"award-number":["2023MSXM107"]}]},{"name":"Chongqing Medical Scientific Research Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau)","award":["2025WSJK096"],"award-info":[{"award-number":["2025WSJK096"]}]},{"name":"Chongqing Medical Scientific Research Project (Joint Project of Chongqing Health Commission and Science and Technology Bureau)","award":["CSTB2024NSCQ-MSX0703"],"award-info":[{"award-number":["CSTB2024NSCQ-MSX0703"]}]},{"name":"Chongqing Municipal Health Commission Medical Research Project","award":["ZDYF2022SHFZ100"],"award-info":[{"award-number":["ZDYF2022SHFZ100"]}]},{"name":"Chongqing Municipal Health Commission Medical Research Project","award":["2024MSXM043"],"award-info":[{"award-number":["2024MSXM043"]}]},{"name":"Chongqing Municipal Health Commission Medical Research Project","award":["2023MSXM107"],"award-info":[{"award-number":["2023MSXM107"]}]},{"name":"Chongqing Municipal Health Commission Medical Research Project","award":["2025WSJK096"],"award-info":[{"award-number":["2025WSJK096"]}]},{"name":"Chongqing Municipal Health Commission Medical Research Project","award":["CSTB2024NSCQ-MSX0703"],"award-info":[{"award-number":["CSTB2024NSCQ-MSX0703"]}]},{"name":"2023 Key Disciplines on Public Health Construction in Chongqing","award":["ZDYF2022SHFZ100"],"award-info":[{"award-number":["ZDYF2022SHFZ100"]}]},{"name":"2023 Key Disciplines on Public Health Construction in Chongqing","award":["2024MSXM043"],"award-info":[{"award-number":["2024MSXM043"]}]},{"name":"2023 Key Disciplines on Public Health Construction in Chongqing","award":["2023MSXM107"],"award-info":[{"award-number":["2023MSXM107"]}]},{"name":"2023 Key Disciplines on Public Health Construction in Chongqing","award":["2025WSJK096"],"award-info":[{"award-number":["2025WSJK096"]}]},{"name":"2023 Key Disciplines on Public Health Construction in Chongqing","award":["CSTB2024NSCQ-MSX0703"],"award-info":[{"award-number":["CSTB2024NSCQ-MSX0703"]}]},{"name":"Senior Medical Talents Programme of Chongqing for Young and Middle Aged","award":["ZDYF2022SHFZ100"],"award-info":[{"award-number":["ZDYF2022SHFZ100"]}]},{"name":"Senior Medical Talents Programme of Chongqing for Young and Middle Aged","award":["2024MSXM043"],"award-info":[{"award-number":["2024MSXM043"]}]},{"name":"Senior Medical Talents Programme of Chongqing for Young and Middle Aged","award":["2023MSXM107"],"award-info":[{"award-number":["2023MSXM107"]}]},{"name":"Senior Medical Talents Programme of Chongqing for Young and Middle Aged","award":["2025WSJK096"],"award-info":[{"award-number":["2025WSJK096"]}]},{"name":"Senior Medical Talents Programme of Chongqing for Young and Middle Aged","award":["CSTB2024NSCQ-MSX0703"],"award-info":[{"award-number":["CSTB2024NSCQ-MSX0703"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Oxazolidinones, novel synthetic antibacterials, inhibit protein biosynthesis and show potent activity against Gram-positive bacteria, including Mycobacterium tuberculosis (MTB). In this study, we aimed to compare the in vitro activity of linezolid (LZD) and four oxazolidinones, including tedizolid (TZD), contezolid (CZD), sutezolid (SZD), and delpazolid (DZD), against multidrug-resistant tuberculosis (MDR-TB) and pre-extensively drug-resistant tuberculosis (pre-XDR-TB) isolates from Hainan. We established their epidemiological cut-off values (ECOFFs) using ECOFFinder software and analyzed mutations in rrl (23S rRNA), rplC, rplD, mce3R, tsnR, Rv0545c, Rv0930, Rv3331, and Rv0890c genes to uncover potential mechanisms of oxazolidinone resistance. This study included 177 MTB isolates, comprising 67 MDR and 110 pre-XDR-TB isolates. Overall, SZD exhibited the strongest antibacterial activity against clinical MTB isolates, followed by TZD and LZD, with CZD and DZD showing equivalent but weaker activity (SZDMIC50 = TZDMIC50 &lt; LZDMIC50 &lt; CZDMIC50 = DZDMIC50; SZDMIC90 &lt; TZDMIC90 = LZDMIC90 &lt; CZDMIC90 = DZDMIC90). Significant differences in MIC distribution were observed for TZD (p &lt; 0.0001), CZD (p &lt; 0.01), SZD (p &lt; 0.0001), and DZD (p &lt; 0.0001) compared to LZD but not between MDR-TB and pre-XDR-TB isolates. We propose the following ECOFFs: SZD, 0.5 \u00b5g\/mL; LZD, TZD, and CZD, 1.0 \u00b5g\/mL; DZD, 2.0 \u00b5g\/mL. No statistically significant differences in resistance rates were observed among these five drugs (p &gt; 0.05). We found that eight MTB isolates (4.52% [8\/177]) resisted these five oxazolidinones. Among these, only one isolate, M26, showed an amino acid substitution (Arg79His) in the protein encoded by the rplD gene, which conferred cross-resistance to TZD and CZD. Three distinct mutations were identified in the mce3R gene; notably, isolate P604 displayed two insertions that contributed to resistance against all five oxazolidinones. However, no significant correlation was observed between mutations in the rrl, rplC, rplD, mce3R, tsnR, Rv0545c, Rv0930, Rv3331, and Rv0890c genes with oxazolidinone resistance in the clinical MTB isolates tested. In summary, this study provides the first report on the resistance of MTB in Hainan to the five oxazolidinones (LZD, TZD, CZD, SZD, and DZD). In vitro susceptibility testing indicated that SZD exhibited the strongest antibacterial activity, followed by TZD and LZD, while CZD and DZD demonstrated comparable but weaker effectiveness. Mutations in rplD and mce3R were discovered, but further research is needed to clarify their role in conferring oxazolidinone resistance in MTB.<\/jats:p>","DOI":"10.3390\/pathogens14030218","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T06:47:17Z","timestamp":1740379637000},"page":"218","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Comparative In Vitro Drug Susceptibility Study of Five Oxazolidinones Against Mycobacterium\u00a0tuberculosis in Hainan, China"],"prefix":"10.3390","volume":"14","author":[{"given":"Jinhui","family":"Dong","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, The Second Affiliated Hospital of Hainan Medical University, Haikou 571199, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Cheng","sequence":"additional","affiliation":[{"name":"Tuberculosis Research Units, Chongqing Public Health Medical Center, Chongqing 400036, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanning","family":"Tang","sequence":"additional","affiliation":[{"name":"Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou 571199, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeteng","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Second Affiliated Hospital of Hainan Medical University, Haikou 571199, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieying","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Second Affiliated Hospital of Hainan Medical University, Haikou 571199, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiping","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Second Affiliated Hospital of Hainan Medical University, Haikou 571199, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuolin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Second Affiliated Hospital of Hainan Medical University, Haikou 571199, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peibo","family":"Li","sequence":"additional","affiliation":[{"name":"Tuberculosis Research Units, Chongqing Public Health Medical Center, Chongqing 400036, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Luo","sequence":"additional","affiliation":[{"name":"Clinical Laboratory, Chongqing Public Health Medical Center, Chongqing 400036, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Second Affiliated Hospital of Hainan Medical University, Haikou 571199, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2024). 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