EMERGENCE OF FLUOROQUINOLONE-RESISTANT TUBERCULOSIS IN NEW-YORK-CITY

22 patients infected with fluoroquinolone-resistant Mycobacterium tube rculosis in New York City were identified between January, 1991, and N ovember, 1993. In 16 patients resistance arose as a result of inadequa te or inappropriate treatment. 6 patients had primary infection with f luoroquinolone-resistant organisms; 5 acquired the organisms nosocomia lly. Seven distinct patterns of restriction-fragment length polymorphi sm were identified in isolates from 21 patients. Fluoroquinolones shou ld be restricted to patients with multidrug-resistant disease or intol erance to other antituberculosis drugs. All patients with multidrug-re sistant tuberculosis should be on directly observed therapy.