Abstract
BackgroundThe multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) has emerged as a global threat. Xinjiang is a multi-ethnic region and suffered second highest incidence of TB in China. However, epidemiological information on MDR and XDR TB is scarcely investigated.Methodology/Principal FindingsA prospective study was conducted to analyze the prevalence of MDR and XDR TB and the differences of drug resistance TB between Chinese Han and other nationalities population at Chest Hospital of Xinjiang Uygur Autonomous Region, China. We performed in vitro drug susceptibility testing of Mycobacterium tuberculosis to first- and second-line anti-tuberculosis drugs for all 1893 culture confirmed positive TB cases that were diagnosed between June 2009 and June 2011. Totally 1117 (59.0%, 95% CI, 56.8%–61.2%) clinical isolates were resistant to ≥1 first-line drugs; the prevalence of MDR TB was 13.2% (95% CI, 11.7%–14.7%), of which, 77 (30.8%; 95% CI, 25.0%–36.6%) and 31 (12.8%; 95% CI, 8.6%–17.0%) isolates were pre-XDR and XDR TB respectively. Among the MDR/XDR TB, Chinese Han patients were significantly less likely to be younger with an odds ratio 0.42 for age 20–29 years and 0.52 for age 40–49 years; P trend = 0.004), and Chinese Han patients has a lower prevalence of XDR TB (9.6%) than all the other nationality (14.9%).Conclusions/SignificanceThe burden of drug resistance TB cases is sizeable, which highlights an urgent need to reinforce the control, detection and treatment strategies for drug resistance TB. However, the difference of MDR and XDR TB between Chinese Han and other nationalities was not observed.
Highlights
A third of the world’s population is estimated to be infected with Mycobacterium tuberculosis (M.tuberculosis) according to the report of World Health Organization [1]
Demographics of the study subjects During June 2009 to June 2011, a total of 9759 clinically diagnosed TB patients were enrolled at Chest Hospital of Xinjiang Uygur Autonomous Region (CHXUAR), providing their sputa for M. tuberculosis test
It was reported that XDR TB prevalence among MDR TB cases ranged from 6.6% to 23.7% worldwide [11]
Summary
A third of the world’s population is estimated to be infected with Mycobacterium tuberculosis (M.tuberculosis) according to the report of World Health Organization [1]. The emergence and spread of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) is further hampering efforts to control and manage the disease. In 2008, about 440 000 MDR TB cases occurred in the world, leading to an estimated 150 000 deaths. XDR TB is a nearly untreatable form of the disease, and has been reported in 58 countries [2] with an estimated rate of 15% among the MDR strains [3]. TB is a significant public health problem in mainland China with an incidence around 100 per 100 000 populations [1]. The multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) has emerged as a global threat. Epidemiological information on MDR and XDR TB is scarcely investigated
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