Prevalence and patterns of drug resistance among pulmonary tuberculosis patients in Hangzhou, China

Qingchun Li,Min Lu,Li Xie,Wei Liu,Han-Zhu Qian,Limin Wu,Ke Wang,Gang Zhao,Le Wang,Yifei Wu

doi:10.1186/s13756-018-0348-7

Abstract

BackgroundTo evaluate prevalence and patterns of drug resistance among pulmonary tuberculosis (TB) patients in Hangzhou City, China.MethodsSputum samples of smear positive TB patients enrolled in 2011 and 2015 were collected and tested for drug susceptibility, and demographic and medical record data were extracted from the electronic database of China Information System for Disease Control and Prevention. Chi-square test was used to compare drug resistance prevalence between new and treated patients and between male and female patients, and Chi-square test for trend was used to compare the prevalence over calendar years 2011 and 2015.ResultsOf 1326 patients enrolled in 2015, 22.3% had resistance to any first-line anti-TB drugs and 8.0% had multi-drug resistance (MDR); drug resistance rates among previously treated cases were significantly higher than among new cases. Significant declines of resistance to isoniazid, rifampin, ethambutol and streptomycin, and MDR from 2011 to 2015 were observed among previously treated patients, while a significant decline of resistance to rifampin was observed among new cases.ConclusionsWhile the prevalence of acquired drug resistance decreased due to due to implementation of DOTS-Plus program, the prevalence of primary drug resistance due to transmission remained high. Greater efforts should be made to screen drug resistance for case finding and to reduce transmission through improving the treatment and management of drug-resistant patients.

Highlights

To evaluate prevalence and patterns of drug resistance among pulmonary tuberculosis (TB) patients in Hangzhou City, China
Hangzhou City Center for Disease Control and Prevention (CDC) is authorized for access to the sociodemographic information and medical records of TB patients who live in Hangzhou in this system
In 2015, a total of 1888 smear-positive pulmonary TB patients who lived in Hangzhou were diagnosed, of whom 1583 (83.8%) had positive sputum culture results and 1332 (70.6%) were positive for M. tuberculosis

Summary

Introduction

To evaluate prevalence and patterns of drug resistance among pulmonary tuberculosis (TB) patients in Hangzhou City, China. China is one of the countries with the highest burden of tuberculosis (TB) disease in the world. Its ranking in total TB cases dropped in 2015 from second to third behind India and Indonesia [1], the epidemic of drug-resistant TB (DR-TB) and multi-drug resistant TB (MDR-TB) is still a severe public health issue in China. A national survey published in 2012 showed 5.7% of new cases and 25.6% of previously treated cases had MDR-TB, both higher than the global averages [2]. The. Li et al Antimicrobial Resistance and Infection Control (2018) 7:61 epidemic trend from 2011 to 2015 in Hangzhou City in eastern China

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