Drug resistance analysis of 154 Mycobacterium tuberculosis strains in southern Qinghai

doi:10.3969/j.issn.1000-6621.2020.12.007

Abstract

Abstract:

Objective To understand the present situation and characteristics of Mycobacterium tuberculosis (MTB) drug resistance and to obtain the drug resistant spectrum of southern Qinghai Province, so as to provide reference for the prevention and control of the epidemic of drug-resistant tuberculosis in southern Qinghai. Methods One hundred and fifty-four strains were identified as MTB from 518 pulmonary tuberculosis patients with positive etiology who were detected in the south of Qinghai (Yushu Prefecture, Guoluo Prefecture, Huangnan Prefecture) from 2018 to 2019. The drug susceptibility tests of the above strains to 6 commonly used anti-tuberculosis drugs (isoniazid, rifampicin, ethambutol, streptomycin, kanamycin and ofloxacin) were carried out, and the drug resistance results were statistically analyzed. Results The overall drug resistant rate of the 154 MTB strains was 37.01% (57/154).The mono-resistant rate, poly-resistant rate and multi-drug resistant rate and rifampicin resistant rate were 23.38% (36/154), 3.25% (5/154), 10.39% (16/154) and 18.18% (28/154) respectively. The overall drug resistant rate (64.52% (20/31)), multi-drug resistant rate (35.48% (11/31)) and rifampicin resistance rate (38.71% (12/31)) among retreated patients were significantly higher than those among new patients (30.08% (37/123), 4.07% (5/123), 13.01% (16/123)) (χ ²=123.00, P<0.05; χ ²=11.68, P<0.01; χ ²=24.07, P<0.01). The drug resistant rate of male (37.89% (36/95)) was significantly higher than that of female (35.59% (21/59)) (χ ²=57.00, P<0.01), and the overall drug resistant rate of middle-aged (45-<60 years old) group (50.00% (7/14)) was significantly higher than that of youth (<45 years old) group (37.50% (48/128)) and elderly (≥60 years old) group (16.67% (2/12)) (χ ²=118.51, P<0.01). The overall drug resistant rate of students (47.22% (17/36)) was significantly higher than that of farmers (34.38% (11/32)), herdsmen (33.93% (19/56)) and other occupations (33.33% (10/30))(χ ²=371.17, P<0.01). Conclusion The drug resistance rates of MTB strains to 6 commonly used anti-tuberculosis drugs are high in the southern area of Qinghai, and it is necessary to strengthen the drug resistance surveillance and treatment to the young and middle-aged groups, students, farmers and herdsmen and other key groups.

Key words: Mycobacterium tuberculosis, Microbial susceptibility tests, Tuberculosis,multi-drug resistant, Data interpretation,statistical, Small-area analysis

JIANG Ming-xia, CHAO Xiu-zhen, WANG Zhao-fen, MA Bin-zhong, MA Yong-cheng, WANG Rong, WANG Chao-cai, LI Er-chen, WEI Yu-jia, LI Yong-xue, ZHANG Qi. Drug resistance analysis of 154 Mycobacterium tuberculosis strains in southern Qinghai[J]. Chinese Journal of Antituberculosis, 2020, 42(12): 1289-1293. doi: 10.3969/j.issn.1000-6621.2020.12.007

Figures/Tables 3

References 21

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地区	MR-TB	PR-TB	MDR-TB	RR-TB	XDR-TB	TDR-TB
玉树州(44株)	6(13.64)	1(2.27)	3(6.82)	1(2.27)	0(0.00)	10(22.73)
果洛州(12株)	2(16.67)	0(0.00)	1(8.33)	4(33.33)	0(0.00)	3(25.00)
黄南州(98株)	28(28.57)	4(4.08)	12(12.24)	23(23.47)	0(0.00)	44(44.90)
合计(154株)	36(23.38)	5(3.25)	16(10.39)	28(18.18)	0(0.00)	57(37.01)
χ²值	72.00	5.00	22.49	27.15	-	7.21
P值	<0.05	<0.05	<0.05	<0.05	-	<0.05

患者分类	MR-TB	PR-TB	MDR-TB	RR-TB	XDR-TB	TDR-TB
初治(123株)	31(25.20)	1(0.81)	5(4.07)	16(13.01)	0(0.00)	37(30.08)
复治(31株)	5(16.13)	4(12.90)	11(35.48)	12(38.71)	0(0.00)	20(64.52)
合计(154株)	36(23.38)	5(3.25)	16(10.39)	28(18.18)	0(0.00)	57(37.01)
χ²值	28.12	5.00	11.68	24.07	-	123.00
P值	<0.01	>0.05	<0.01	<0.01	-	<0.05

社会学特征	例数	MR-TB	PR-TB	RR-TB	MDR-TB	TDR-TB	χ²值	P值
性别							57.00	<0.01
男	95	24(25.26)	4(4.21)	16(16.84)	8(8.42)	36(37.89)
女	59	12(20.34)	1(1.69)	12(20.34)	8(13.56)	21(35.59)
年龄(岁)							118.51	<0.01
<45	128	31(24.22)	5(3.91)	22(17.19)	12(9.38)	48(37.50)
45~	14	3(21.43)	0(0.00)	4(28.57)	2(14.29)	7(50.00)
60~79	12	2(16.67)	0(0.00)	2(16.67)	2(16.67)	2(16.67)
民族							288.37	<0.01
藏族	135	30(22.22)	5(3.70)	22(16.30)	11(8.15)	46(34.07)
蒙古族	14	4(28.57)	0(0.00)	2(14.29)	2(14.29)	6(42.86)
其他	5	2(2/5)	0(0/5)	4(4/5)	3(3/5)	5(5/5)
职业							371.17	<0.01
学生	36	14(38.89)	1(2.78)	7(19.44)	2(5.56)	17(47.22)
牧民	56	10(17.86)	2(3.57)	10(17.86)	7(12.50)	19(33.93)
农民	32	8(25.00)	1(3.13)	6(18.75)	2(6.25)	11(34.38)
其他	30	4(13.33)	1(3.33)	5(16.67)	5(16.67)	10(33.33)