Analysis of drug susceptibility testing results of 881 patients with suspected multidrug-resistant pulmonary tuberculosis

doi:10.3969/j.issn.1000-6621.2018.02.014

Abstract

Abstract: Objective

To analyze the drug resistance situation of patients with suspected multidrug-resistant pulmonary tuberculosis (MDR-PTB) in TB control institutes and TB designated hospitals in Beijing, to provide suggestions for clinical diagnosis, treatment, and control.

Methods

We made a retrospective analysis, including preliminary bacteria identification and drug susceptibility testing of the bacteria isolated from the positive sputum specimens of the 881 suspected MDR-PTB patients from 14 TB control institutes and 6 TB designated hospitals in Beijing between January 2014 and December 2016. We collected their drug susceptibility testing results against INH, RFP, Sm, EMB, Lfx, Am, Cm, Pto, and PAS. SPSS 17.0 was used for statistical analysis. We analyzed and summarized the drug resistance situation of suspected MDR-PTB patients in those 3 years.

Results

In the 881 suspected MDR-PTB patients, the isolation rate of Mycobacterium tuberculosis complex group was 88.6% (781/881). The isolation rate of non-tuberculous mycobacterium (NTM) was 11.4% (100/881). The total drug resistant rate of the clinical isolates of Mycobacterium tuberculosis complex group was 33.3% (260/781). The multidrug-resistance (MDR) rate was 17.2% (134/781). The proportion of high-level of resistance rates (defined as >67.0%) against the four first-line TB drugs (INH, RFP, Sm and EMB) was 69.0% (127/184), 57.1% (92/161), 60.5% (107/177) and 31.7%(19/60) respectively.

Conclusion

It is very necessary to carry out a drug sensitive test for the suspected MDR-PTB patients in Beijing, and the epidemic situation of TB resistance faced in Beijing is still very severe.

Key words: Tuberculosis, pulmonary, Drug resistance, bacterium, Microbial sensitivity tests, Beijing

Xin-yu YANG,Jun-li YI,Qing XING,Li-li TIAN,Xiao-wei DAI,Jie ZHANG,Nen-han WANG,Yan-feng ZHAO,Su-min WANG,Bei-chuan DING. Analysis of drug susceptibility testing results of 881 patients with suspected multidrug-resistant pulmonary tuberculosis[J]. Chinese Journal of Antituberculosis, 2018, 40(2): 183-188. doi: 10.3969/j.issn.1000-6621.2018.02.014

Figures/Tables 5

References 14

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药物种类	合计		初治(462例)		复治(319例)		χ²值	P值
药物种类	耐药例数	耐药率(%)	耐药例数	耐药率(%)	耐药例数	耐药率(%)	χ²值	P值
INH	184	23.6	78	16.9	106	33.2	28.00	<0.001
RFP	161	20.6	67	14.5	94	29.5	25.82	<0.001
Sm	177	22.7	90	19.5	87	27.3	6.54	<0.05
EMB	60	7.7	29	6.3	31	9.7	3.15	0.076
Lfx	74	9.5	34	7.4	40	12.5	5.90	<0.05
Am	19	2.4	9	1.9	10	3.1	1.12	0.290
Cm	18	2.3	8	1.7	10	3.1	1.65	0.199
Pto	6	0.8	1	0.2	5	1.6	2.92	0.088
PAS	36	4.6	16	3.5	20	6.3	3.38	0.066

药敏结果	初治(462例)		复治(319例)		合计(781例)
药敏结果	例数	构成比(%)	例数	构成比(%)	例数	构成比(%)
全敏感	343	74.2	178	55.8	521	66.7
单耐药	35	7.6	37	11.6	72	9.2
多耐药	29	6.3	25	7.8	54	6.9
耐多药	55	11.9	79	24.8	134	17.2

社会人口学特征	初治(462例)		复治(319例)		合计(781例)
社会人口学特征	例数	构成比(%)	例数	构成比(%)	例数	构成比(%)
性别
男	353	76.4	254	79.6	607	77.7
女	109	23.6	65	20.4	174	22.3
年龄(岁)
0~	16	3.5	5	1.6	21	2.7
20~	168	36.4	89	27.9	257	32.9
40~	148	32.0	129	40.4	277	35.5
≥60	130	28.1	96	30.1	226	28.9
户籍
本市	306	66.2	208	65.2	514	65.8
外地	156	33.8	111	34.8	267	34.2

社会人口学特征	初治(55例)		复治(79例)		合计(134例)
社会人口学特征	例数	构成比(%)	例数	构成比(%)	例数	构成比(%)
性别
男	47	85.5	65	82.3	112	83.6
女	8	14.5	14	17.7	22	16.4
年龄(岁)
0~	2	3.7	2	2.5	4	3.0
20~	23	41.8	35	44.3	58	43.3
40~	23	41.8	27	34.2	50	37.3
≥60	7	12.7	15	19.0	22	16.4
户籍
本市	32	58.2	38	48.1	70	52.2
外地	23	41.8	41	51.9	64	47.8

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