Linezolid resistance in patients with drug-resistant TB
Abstract
Dear Editor, Multidrug-resistant TB (MDR-TB) continues to be a global public health issue. Linezolid (LZD) has been shown to be one of the most effective drugs against MDR-TB.1 A meta-analysis of 12,030 patients showed treatment success was positively associated with LZD use (adjusted risk difference 0.15, 95% confidence interval [CI] 0.11–0.18) compared to not using the drug.2 New treatment regimens containing bedaquiline (BDQ), pretomanid, LZD with or without moxifloxacin (BPaLM/BPaL) have been recommended by the WHO for MDR-TB programmes.3 Unfortunately, global resistance to LZD has been observed, especially in India, which has a high burden of MDR-TB.4–6 Potential risk factors to acquired LZD resistance are addition of LZD to a failing or inadequate regimen, or interruption of LZD due to adverse events or loss to follow-up.7 In a recent metaanalysis, pooled frequency of LZD resistance in clinical isolates of MDR-TB bacteria was reported to be 4.2%.4 However, the majority of the studies included in this analysis were from China and Turkey, with only one carried out in India.4 Here we report on the clinical/epidemiological profile and treatment outcome of patients with LZD resistance admitted to a Médecins Sans Frontières (MSF) clinic in Mumbai, India. This was a retrospective, cohort study using routinely collected clinical data from 1st January 2016 to 31st December 2020. Mumbai is one of India’s most populous cities, and has a high prevalence of drug-resistant TB…
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