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. 2022 Aug 30:13:955050.
doi: 10.3389/fphar.2022.955050. eCollection 2022.

Linezolid resistance in multidrug-resistant mycobacterium tuberculosis: A systematic review and meta-analysis

Taher Azimi  1 , Saeed Khoshnood  2   3 , Arezoo Asadi  4 , Mohsen Heidary  5   6 , Hassan Mahmoudi  7   8 , Vahab Hassan Kaviar  2 , Masoume Hallajzadeh  9   10 , Mohammad Javad Nasiri  11
Affiliations

Linezolid resistance in multidrug-resistant mycobacterium tuberculosis: A systematic review and meta-analysis

Taher Azimi et al. Front Pharmacol. .

Abstract

Introduction: Linezolid (LNZ) is an effective antibiotic to treat patients with multidrug-resistant tuberculosis (MDR-TB) treatment failure. M. tuberculosis strains resistant to isoniazid and rifampin are defined as MDR-TB. In recent years, resistance to LNZ among MDR-TB cases has been reported in several different countries. In this study, we performed a systematic review and meta-analysis to investigate the prevalence of LNZ resistance among MDR-TB isolates. Methods: The databases of Embase, PubMed/Medline, and Web of Science were searched systematically from January 2000 to April 2021. Statistical analyses were performed by using Comprehensive Meta-Analysis software. Heterogeneity was reported by using the t-squared statistic and Q-statistic. Begg's rank correlation in combination with the funnel plot were used to evaluate any possible publication bias. Results: In total, 25 studies were selected for meta-analysis from 14 different countries; the majority was from China (n = 5) and Turkey (n = 4). Moreover, 7,366 patients were infected with MDR M. tuberculosis. Among the study population, 98 patients were co-infected with HIV, and 18 patients with hepatitis C virus (HCV). Furthermore, 28 cases had diabetes, and139 cases were alcohol abuser. Overall, 4,956 MDR M. tuberculosis strains were isolated from TB patients. The pooled frequency of LNZ resistance among the clinical isolates of MDR M. tuberculosis was 4.2% (95%). Begg's (p = 0.72) test showed no evidence of publication bias. Conclusion: LNZ resistance among MDR M. tuberculosis isolates is increasing. On the other hand, long-term treatment of MDR-TB cases with LNZ alone is associated with several adverse effects. Thus, it is recommended that newer anti-TB drugs, including bedaquiline and delamanid, in combination with linezolid could increase its effectiveness and decrease toxicities. However, more studies should be done in this field.

Keywords: MDR-TB; TB; linezolid; meta-analysis; resistance; tuberculosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram detailing review process and study selection.
FIGURE 2
FIGURE 2
Pooled prevalence of linezolid resistance in multidrug-resistant Mycobacterium tuberculosis isolates. CI: confidence interval.
FIGURE 3
FIGURE 3
Funnel plot of the meta-analysis of Linezolid resistance in multidrug-resistant Mycobacterium tuberculosis isolates.
See this image and copyright information in PMC

References

    1. Ahmed I., Jabeen K., Inayat R., Hasan R. (2013). Susceptibility testing of extensively drug-resistant and pre-extensively drug-resistant Mycobacterium tuberculosis against levofloxacin, linezolid, and amoxicillin-clavulanate. Antimicrob. Agents Chemother. 57 (6), 2522–2525. 10.1128/AAC.02020-12 - DOI - PMC - PubMed
    1. Alcalá L., Ruiz-Serrano M. J., Turégano C. P-F., De Viedma D. G., Díaz-Infantes M., Marin-Arriaza M., et al. (2003). In vitro activities of linezolid against clinical isolates of Mycobacterium tuberculosis that are susceptible or resistant to first-line antituberculous drugs. Antimicrob. Agents Chemother. 47 (1), 416–417. 10.1128/aac.47.1.416-417.2003 - DOI - PMC - PubMed
    1. Azimi T., Nasiri M. J., Zamani S., Hashemi A., Goudarzi H., Fooladi A. A. I., et al. (2018). High genetic diversity among Mycobacterium tuberculosis strains in Tehran, Iran. J. Clin. Tuberc. Other Mycobact. Dis. 11, 1–6. 10.1016/j.jctube.2018.01.001 - DOI - PMC - PubMed
    1. Azimi T., Shariati A., Fallah F., Imani Fooladi A. A., Hashemi A., Goudarzi H., et al. (2017). Mycobacterium tuberculosis genotyping using MIRU-VNTR typing. J. Mazandaran Univ. Med. Sci. 27 (149), 40–48.
    1. Bektöre B., Haznedaroglu T., Baylan O., Ozyurt M., Ozkutuk N., Satana D., et al. (2013). Investigation of extensive drug resistance in multidrug resistance tuberculosis isolates. Mikrobiyol. Bul. 47 (1), 59–70. 10.5578/mb.4229 - DOI - PubMed

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