Definitions of resistance in multidrug-resistant tuberculosis (MDR TB) and extensively drug-resistant tuberculosis (XDR TB) have been updated. Pre–XDR TB, defined as MDR TB with additional resistance to fluoroquinolones, and XDR TB, with additional resistance to bedaquiline or linezolid, are frequently associated with treatment failure and toxicity. We retrospectively determined the effects of pre-XDR/XDR TB resistance on outcomes and safety of MDR TB treatment in France. The study included 298 patients treated for MDR TB at 3 reference centers during 2006–2019. Of those, 205 (68.8%) cases were fluoroquinolone-susceptible MDR TB and 93 (31.2%) were pre-XDR/XDR TB. Compared with fluoroquinolone-susceptible MDR TB, pre-XDR/XDR TB was associated with more cavitary lung lesions and bilateral disease and required longer treatment. Overall, 202 patients (67.8%) had favorable treatment outcomes, with no significant difference between pre-XDR/XDR TB (67.7%) and fluoroquinolone-susceptible MDR TB (67.8%; p = 0.99). Pre-XDR/XDR TB was not associated with higher risk for serious adverse events.

耐多药结核病 (MDR TB) 和广泛耐药结核病 (XDR TB) 的耐药性定义已更新。前广泛耐药结核病被定义为对氟喹诺酮类药物具有额外耐药性的耐多药结核病，而广泛耐药结核病则对贝达喹啉或利奈唑胺具有额外耐药性，通常与治疗失败和毒性相关。我们回顾性地确定了广泛耐药前/广泛耐药结核病耐药性对法国耐多药结核病治疗结果和安全性的影响。该研究纳入了 2006 年至 2019 年期间在 3 个参考中心接受耐多药结核病治疗的 298 名患者。其中，205 例 (68.8%) 病例为氟喹诺酮敏感耐多药结核病，93 例 (31.2%) 为广泛耐药前/广泛耐药结核病。与氟喹诺酮类药物敏感的耐多药结核病相比，广泛耐药前/广泛耐药结核病与更多的肺部空洞病变和双侧疾病相关，并且需要更长的治疗时间。总体而言，202 名患者 (67.8%) 获得了良好的治疗结果，广泛耐药前/广泛耐药结核病 (67.7%) 和氟喹诺酮类药物敏感耐多药结核病 (67.8%；p = 0.99) 之间没有显着差异。广泛耐药前/广泛耐药结核病与严重不良事件的较高风险无关。