Abstract
BackgroundThe spread of multidrug-resistant tuberculosis (MDR-TB) Mycobacterium tuberculosis (M. tuberculosis) strains has been a big challenge to the TB control and prevention in China. Knowledge about patterns of drug resistance in TB high-burden areas of China is crucial to develop appropriate control strategies. We conducted a comprehensive investigation of the resistance pattern of M. tuberculosis in Heilongjiang Province.Methods1427 M. tuberculosis clinical strains were isolated from pulmonary TB patients hospitalized between 2007 and 2012. The susceptibility of the isolates to the first-line anti-TB drugs and the resistance of MDR M. tuberculosis to fluoroquinolones were examined. We also performed a statistical analysis to identify the correlated risk factors for high burden of MDR-TB.ResultsThe global resistance rates of 2007–2012 to the first-line drugs and MDR were 57.0 and 22.8 %, respectively. Notably, the primary MDR-TB and pan-resistance rates were as high as 13.6 and 5.0 %, respectively. Of MDR M. tuberculosis isolates (2009), approximately 13 % were not susceptible to any of the fluoroquinolones tested. Being age of 35 to 54, high re-treatment proportion, the presence of cavity lesion, and high proportion of shorter hospitalization are correlated with the development of MDR-TB.ConclusionsThe high prevalence of drug resistant, MDR-TB, and fluoroquinolone-resistant MDR-TB is a big concern for TB control. More importantly, in order to control the development of MDR-TB effectively, we need to pay more attention to the primary resistance. Targeting reducing the prevalence of the risk factors may lead to better TB control in China.
Highlights
The spread of multidrug-resistant tuberculosis (MDR-TB) Mycobacterium tuberculosis (M. tuberculosis) strains has been a big challenge to the TB control and prevention in China
The risks associated with drug resistant- and MDR-TB include a history of retreatment using anti-mycobacterial drugs, having cavities, Beijing genotype epidemic, low socio-economic status, age and Directly observed treatment short course (DOTS) implementation
Mycobacterial culture and drug susceptibility testing (DST) to first-line drugs Mycobacterial cultures were obtained from clinical specimens after incubation in a BACTEC Mycobacterium Growth Indicator Tube (MGIT) 960 Automated System (BD Diagnostic Systems, Franklin Lakes, NJ, USA)
Summary
The spread of multidrug-resistant tuberculosis (MDR-TB) Mycobacterium tuberculosis (M. tuberculosis) strains has been a big challenge to the TB control and prevention in China. The spread of drug-resistant and multidrug-resistant (MDR) tuberculosis (TB) is a severe global health issue. In recent years, both the incidence and prevalence of TB in China have steadily declined [1]. The epidemic trends of drug resistant-TB in different geographic areas of China vary greatly, and recently, the spread of TB in China has been caused by active domestic migration, resulting in a significant public health issue. The rates of any resistance to first-line drugs were 38.9 and 36.2 % for new cases and 70.9 and 67.7 % for retreated cases in Heilongjiang Province in 2002 and 2004, respectively, based on data from population-based drug resistance investigations [2,3,4]. The factors vary depending on the study [1, 5,6,7,8]
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