{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:32:47Z","timestamp":1787031167830,"version":"build-2736575974"},"reference-count":40,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5,3]]},"abstract":"<jats:p>\n                    In Saudi Arabia, there were no nationwide screening studies conducted so far to determine the aminoglycoside and fluoroquinolone resistance among multidrug-resistant tuberculosis (MDR-TB) isolates. Therefore, as the first attempt in the country, a retrospective analysis has been conducted on a nationwide collection of 2,956\n                    <jats:italic>M. tuberculosis<\/jats:italic>\n                    clinical isolates screened with phenotypic drug susceptibility testing to define MDR-TB. Enrolled MDR-TB isolates were subjected to second-line drug susceptibility testing, detection of mutations conferring resistance to aminoglycosides and fluoroquinolone, followed by 24-loci mycobacterial interspersed repetitive unit\u2013variable number of tandem repeat typing and spoligotyping. Overall, 83 isolates were identified as MDR-TB, and 13 (15.7%) isolates showed resistance to second-line drugs. Moxifloxacin (low level) showed higher resistant rates (10.8%) followed by ofloxacin (7.2%), capreomycin (3.6%), kanamycin (3.6%), and amikacin (2.4%). Overall fluoroquinolone resistance was 12%, whereas aminoglycoside resistance was 7.2%. Predominant mutations conferring resistance to fluoroquinolone were found in\n                    <jats:italic>gyrA<\/jats:italic>\n                    A90V and D94G, whereas aminoglycoside resistance was observed only with\n                    <jats:italic>rrs<\/jats:italic>\n                    gene A1401G mutation. The corresponding strain lineages predominated with Indo-Oceanic and East-African Indian origin. Interestingly, none of the isolates with second-line drug resistance was defined as extensively drug-resistant TB (XDR-TB). Surprisingly, many isolates (50.6%) were panresistant to first-line drugs. Saudi Arabia faces considerable burden of fluoroquinolone- and aminoglycoside-resistant MDR-TB. Higher incidence of panresistant MDR-TB reveals a threat for the emergence of XDR-TB strains in the near future.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.16-0579","type":"journal-article","created":{"date-parts":[[2017,3,3]],"date-time":"2017-03-03T09:07:08Z","timestamp":1488532028000},"page":"1066-1070","source":"Crossref","is-referenced-by-count":7,"title":["First Insight Into the Fluoroquinolone and Aminoglycoside Resistance of Multidrug-Resistant Mycobacterium tuberculosis in Saudi Arabia"],"prefix":"10.4269","volume":"96","author":[{"given":"Bright","family":"Varghese","sequence":"first","affiliation":[{"name":"Mycobacteriology Research Section, Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahal","family":"Al-Hajoj","sequence":"additional","affiliation":[{"name":"Mycobacteriology Research Section, Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Lancet","first-page":"1861","article-title":"Epidemiology of antituberculosis drug resistance 2002\u201307: an updated analysis of the Global Project on Anti-Tuberculosis Drug Resistance Surveillance","volume":"373","author":"Wright","year":"2009"},{"key":"ref2","series-title":"Global Tuberculosis Control: 2012","author":"World Health Organization (WHO)","year":"2012"},{"key":"ref3","series-title":"Trends Genet","first-page":"160","article-title":"The heterogeneous evolution of multidrug-resistant Mycobacterium tuberculosis","volume":"29","author":"Muller","year":"2013"},{"key":"ref4","series-title":"Lancet","first-page":"1830","article-title":"Multidrug-resistant and extensively drug-resistant tuberculosis: a threat to global control of tuberculosis","volume":"375","author":"Gandhi","year":"2010"},{"key":"ref5","series-title":"Clin Infect Dis","first-page":"338","article-title":"Extensively drug-resistant tuberculosis: are we learning from history or repeating it?","volume":"45","author":"Dukes Hamilton","year":"2007"},{"key":"ref6","series-title":"Multi Drug and Extensively Drug Resistant TB (M\/XDR-TB). 2010 Global Report on Surveillance and Response","author":"World Health Organization (WHO)","year":"2010"},{"key":"ref7","series-title":"Science","first-page":"1554","article-title":"Infectious disease. 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