{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:23:07Z","timestamp":1787764987370,"version":"build-2784847793"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Fluoroquinolone (FQ) antibiotics are among the most potent second-line antitubercular drugs these days. The aim of the study was to analyze the frequency and pattern of genetic mutation in preextensive (pre-XDR) and extensively drug-resistant\n                      <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                      using second-line line probe assay (LPA) and to compare drug-resistant mutations with different treatment outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Sputum, lymph node aspirate, and cold accesses from patients with rifampicin-resistant Tuberculosis (TB) were subjected to first-line and second-line LPA (Genotype MTBDRsl by Hain Life Science, Germany) to assess additional drug resistance to fluoroquinolones (levofloxacin and moxifloxacin). Final treatment outcomes as per the National TB Elimination Program were assessed and compared with the mutation profile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      One hundred and fifty subjects were observed to have mutations associated with resistance to FQs and constituted the final study population. The most frequent mutation observed among GyrA drug resistance mutation was D94G (Gyr A MUT3C, 44\/150, 66%) corresponding to high-level resistance to levofloxacin and moxifloxacin. The same mutation was associated with poor treatment outcome as died or treatment failure (odds ratio 2.50, relative risk 1.67,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.043). The most common hetero-resistance mutation pattern observed in GyrA gene was wild type plus Asp94Gly mutation in 24.6% of isolates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      GyrA MUT3C hybridization corresponding to single-point mutation of aspartic acid to glycine at codon 94 constitutes the most common mutation in GyrA gene locus in\n                      <jats:italic toggle=\"yes\">M<\/jats:italic>\n                      .\n                      <jats:italic toggle=\"yes\">tuberculosis<\/jats:italic>\n                      with significant association with treatment outcome as died compared to those with treatment outcome as cured.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijmy.ijmy_116_23","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T02:00:26Z","timestamp":1741140026000},"page":"294-298","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Fluoroquinolone Resistance Mutations among Mycobacterium tuberculosis and their Interconnection with Treatment Outcome"],"prefix":"10.4103","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3253-8812","authenticated-orcid":false,"given":"Ramakant","family":"Dixit","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Ajmer, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil","family":"Mohan","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Ajmer, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankur","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Ajmer, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka Soni","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Microbiology, J. L. N. Medical College, Ajmer, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarun","family":"Patni","sequence":"additional","affiliation":[{"name":"State TB Demonstration Center, JLN Medical College, Ajmer, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mukesh","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Ajmer, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshan Kumar","family":"Meena","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Ajmer, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,9,15]]},"reference":[{"key":"R3-20250306","doi-asserted-by":"crossref","first-page":"42","DOI":"10.2991\/jegh.k.191215.003","article-title":"Second-line drug resistance characterization in Mycobacterium tuberculosis by genotype MTBDRsl assay","volume":"10","author":"Sethi","year":"2020","journal-title":"J Epidemiol Glob Health"},{"key":"R4-20250306","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1186\/s12879-019-3931-5","article-title":"Treatment outcomes of drug resistant tuberculosis patients in Morocco:Multi-centric prospective study","volume":"19","author":"El Hamdouni","year":"2019","journal-title":"BMC Infect Dis"},{"key":"R6-20250306","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1086\/653115","article-title":"Treatment outcomes among patients with extensively drug-resistant tuberculosis:Systematic review and meta-analysis","volume":"51","author":"Jacobson","year":"2010","journal-title":"Clin Infect Dis"},{"key":"R7-20250306","doi-asserted-by":"crossref","first-page":"339","DOI":"10.5588\/ijtld.14.0814","article-title":"Concordance of Mycobacterium tuberculosis fluoroquinolone resistance testing:Implications for treatment","volume":"19","author":"Farhat","year":"2015","journal-title":"Int J Tuberc Lung Dis"},{"key":"R9-20250306","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/jor2010001","article-title":"Risk factors and treatment outcome analysis associated with second-line drug-resistant tuberculosis","volume":"2","author":"Aaina","year":"2022","journal-title":"J Respir"},{"key":"R11-20250306","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1186\/s12890-020-1172-4","article-title":"Fluoroquinolone resistance and mutational profile of gyrA in pulmonary MDR tuberculosis patients","volume":"20","author":"Kabir","year":"2020","journal-title":"BMC Pulm Med"},{"key":"R12-20250306","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1093\/jac\/dkv360","article-title":"Specific gyrA gene mutations predict poor treatment outcome in MDR-TB","volume":"71","author":"Rigouts","year":"2016","journal-title":"J Antimicrob Chemother"},{"key":"R13-20250306","doi-asserted-by":"crossref","first-page":"e0009068","DOI":"10.1371\/journal.pntd.0009068","article-title":"Drug resistance gene mutations and treatment outcomes in MDR-TB:A prospective study in Eastern China","volume":"15","author":"Liu","year":"2021","journal-title":"PLoS Negl Trop Dis"}],"container-title":["The International Journal of Mycobacteriology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijmy.ijmy_116_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:55:11Z","timestamp":1787763311000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijmy.ijmy_116_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ijmy.ijmy_116_23","relation":{},"ISSN":["2212-5531","2212-554X"],"issn-type":[{"value":"2212-5531","type":"print"},{"value":"2212-554X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7]]},"assertion":[{"value":"2023-05-05","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-28","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}