关键词: 分枝杆菌,结核, 结核,抗多种药物性, 流行病学研究特征(主题), 因素分析,统计学

Abstract:

Objective To investigate the baseline and related factors of drug-resistant pulmonary tuberculosis who had admitted to the tuberculosis designated hospital in Hainan Province from 2015 to 2019, in order to provide scientific basis for the control and prevention of tuberculosis in Hainan. Methods One thousand two hundred and twenty-nine patients who were cultured positive of Mycobacterium, confirmed as Mycobacterium tuberculosis by Mycobacterium species identification testing and had anti-tuberculosis drug susceptibility testing (including rifampin, isoniazid, streptomycin and ethambutol) in the tuberculosis designated hospital of Hainan from January 2015 to December 2019 were enrolled. Patients’ information was collected retrospectively. Conditional logistic regression model was used to analysis the related factors of multidrug-resistance. Results The drug resistance rate of pulmonary tuberculosis patients was 41.66% (512/1229), of which in newly treated patients and retreated patients were 21.01% (137/652) and 64.99% (375/577), respectively, and the difference was statistically significant (χ²=243.600, P<0.001). The drug resistance rate was rifampicin (32.06%, 394/1229) >isoniazid (31.49%, 387/1229) >streptomycin (21.24%, 261/1229) >ethambutol (9.93%, 122/1229). From 2015 to 2019, the drug resistance rate of pulmonary tuberculosis patients decreased by 5.10% ((0.391/0.482) ^1/4-1) annually, and the multidrug-resistance rate decreased by 4.07% ((0.249/0.294)^1/4-1) annually, and the difference was statistically significant ({\chi }_{\mathrm{trend}}^2=8.837, P=0.003). Multivariate conditional logistic regression analysis showed that the risk of multidrug-resistance in patients with retreatment was 12.305 times of that in patients with initial treatment, with 95% confidence interval of (6.778-22.337); the multidrug-resistance risk of patients with hyperuricemia was 2.720 times of that in patients without hyperuricemia, with 95% confidence interval of (1.064-6.951); the rate of multidrug-resistance in pulmonary tuberculosis patients with pulmonary cavity was 2.017 times of that in patients without pulmonary cavity, with 95% confidence interval of (1.143-3.560). Conclusion The level of drug resistance of pulmonary tuberculosis patients is relatively high and severe in Hainan. Pulmonary tuberculosis patients with retreatment, hyperuricemia and pulmonary cavity are the high risk group of multi-drug resistant patients, and should be monitored.

Key words: Mycobacterium tuberculosis, Tuberculosis,multidrug-resistant, Epidemiologic study characteristics as topic, Factor analysis,statistical