Abstract:

Objective To analyze the drug susceptible test results to rifampin and isoniazid among the patients with pulmonary tuberculosis (PTB) in Kashi, Xinjiang. Methods The sputum samples and patients’ information were collected from 1307 PTB patients, who were diagnosed from January 1, 2019 to June 30, 2019 in 11 cities/counties in Kashi, Xinjiang according to the Diagnosis standard of pulmonary tuberculosis (WS 288—2017). The drug susceptible test to rifampin and isoniazid were performed by using gene mutation detection kits for rifampin resistance and isoniazid resistance. The statistical analysis of drug resistance situation in patients with different age groups, different genders, different treatment histories and different regions was conducted. Chi-square test was used to compare the differences of drug resistance rate between different patient groups. A P-value <0.05 was considered as statistically significant. Results Among 1307 patients, 198 cases were resistant to rifampin and the drug resistance rate was 15.15%; 151 cases were resistant to isoniazid and the drug resistance rate was 11.55%; 63 cases were resistant to both rifampin and isoniazid and the multidrug-resistance (MDR) rate was 4.82%. There were no statistically significant differences of rifampin resistant rate, isoniazid resistant rate and MDR rate between male and female patient groups (rifampin, 15.71% (110/700) vs 14.57% (88/604), χ²=0.330, P=0.566; isoniazid, 10.71% (75/700) vs 12.42% (75/604), χ ²=0.924, P=0.337; MDR, 4.57% (32/700) vs 5.13% (31/604), χ ²=0.222, P=0.638). There were no statistically significant differences of rifampin resistant rate, isoniazid resistant rate and MDR rate between new and retreated patient groups (rifampin, 15.46% (160/1035) vs 16.32% (31/190), χ ²=0.090, P=0.765; isoniazid, 11.30% (117/1035) vs 14.74% (28/190), χ ²=1.812, P=0.178; MDR, 4.73% (49/1035) vs 6.32% (12/190), χ ²=0.849, P=0.357). The MDR rate was the highest among the patient group aging 60-70 (6.12%, 21/343). The highest rifampin resistance rate (21.32%, 29/136) and the highest isoniazid resistance rate (14.71%, 20/136) were found to be in the patient group aging 30-40. The highest rates of MDR (10.59%, 9/85), rifampin resistance (25.88%, 22/85) and isoniazid resistance (28.24%, 24/85) were found in Kashi City among the 11 cities/counties in Kashi area. Conclusion The situation of drug-resistant TB is relatively serious in Kashi. Drug-resistance screening should be strengthened to timely detect drug-resistant TB patients and effective chemotherapy regimens should be designed and provided.

Key words: Mycobacterium tuberculosis, Microbial sensitivity tests, Rifampin, Isoniazid, Tuberculosis,multidrug-resistant, Small-area analysis