Abstract:

Objective To understand the status of drug resistance in children with tuberculosis and to identify risk factors associated with drug resistance. Methods Information of 314 tuberculosis patients under 18 years old admitted to Shenyang Tenth People’s Hospital from January 31, 2017 to December 31, 2019 were collected. 178 cases were male, and 136 cases were female. The age ranged from 1 to 18 years old, median age (M(Q₁,Q₃)) was 17 (15,18). There were 253 primary treated cases and 61 retreated cases. Drug susceptibility test results of positive culture isolates from those 314 patients were analyzed. Risk factors for multidrug-resistant tuberculosis (MDR-TB) in children were analyzed using multivariate logistic regression. Results The overall drug resistance rate, primary treated drug resistance rate and retreatment drug resistance rate of 314 clinical isolates of Mycobacterium tuberculosis (MTB) were 27.1% (85/314), 20.9% (53/253) and 52.5% (32/61) respectively, and the retreatment drug resistance rate was significantly higher than the primary treated drug resistance rate (χ²=24.771,P=0.000). The overall,primary treated and retreatment multidrug-resistance rate were 10.8% (34/314), 6.3% (16/253) and 29.5% (18/61) respectively. The retreatment multidrug-resistance rate was significantly higher than that of primary treated multidrug-resistance rate (χ²=27.360, P=0.000). Logistic multivariate regression analysis showed that retreatment (OR=5.671, 95%CI=2.228-14.435, P=0.000), 14-18 years old (OR=2.235, 95%CI=1.568-3.562, P=0.032), complicated with malnutrition (OR=1.908, 95%CI=1.337-2.447, P=0.034), smoking (OR=1.225, 95%CI=1.013-2.740, P=0.046) were risk factors related to MDR-TB in children. Conclusion The current situation of tuberculosis drug resistance in children is severe. Retreatment, 14-18 years old, malnutrition and smoking history are risk factors of MDR-TB in children.

Key words: Mycobacterium tuberculosis, Child, Tuberculosis, multidrug-resistant, Factor analysis, statistical