Population-Level Frequency of Fluoroquinolone Resistance by Whole-Genome Sequencing Drug Predictions in Mycobacterium Tuberculosis Complex Isolates in England from 2017 Through 2023

Fluoroquinolones are increasingly important for anti-tuberculosis (TB) treatment. Identifying fluoroquinolone resistance (FR) is essential. Using sequencing data from over 16 000 unselected isolates, this first English survey of FR, found it present in 1.4% overall and 23.9% of multidrug-resistant TB. Routine sequencing allows clinically-relevant resistance surveillance and should be widely adopted.