Analysis of the drug resistance surveillance results of Mycobacterium tuberculosis in Fujian Province from 2016 to 2019

doi:10.3969/j.issn.1000-6621.2021.09.012

Abstract

Abstract:

Objective To understand the drug resistance of Mycobacterium tuberculosis complex isolates from the drug-resistant surveillance sites in Fujian province from 2016 to 2019, and to analyze the trend of change in drug resistance, in order to provide reference for tuberculosis control. Methods The culture positive isolates from 9 drug-resistant surveillance sites in Fujian province were identified by PNB and TCH, and the Mycobacterium tuberculosis complex (MTPC) strains were performed the drug susceptibility test by proportion method. The tested 9 drugs included INH, RFP, SM, EMB, Km, Ofx, Cm, Pto and PAS. The drug resistance spectrum and resistant level was described. Results Among the 1434 MTPC strains, 1261 strains were isolated from new cases and 173 were isolated from re-treated cases. The overall drug resistance rate was 19.04% (273/1434), the mono-resistance rate was 11.65% (167/1434), the poly-resistance rate was 3.56% (51/1434), and the MDR rate was 3.84% (55/1434). The overall drug resistance rate (28.90%, 50/173) and MDR rate (12.14%, 21/173) in the retreated cases were significantly higher than those (17.68% (223/1261), 2.70% (34/1261)) in the new cases (χ²=12.419, P=0.000;χ²=36.775, P=0.000).The spectrum consisted of 42 different typed of drug resistance. Resistance rate of 9 drugs were Sm (9.90%, 142/1434), INH (8.30%, 119/1434), RFP (5.93%, 85/1434), Ofx (3.63%, 52/1434), EMB (2.30%, 33/1434), Km (0.98%, 14/1434), Cm (0.77%, 11/1434), PAS (0.77%, 11/1434), Pto (0.63%, 9/1434). The overall drug resistance rates from 2016 to 2019 were 17.69% (66/373), 22.34% (63/282), 20.31% (78/384) and 16.71% (66/395) respectively, which showed no trend of change ( $χ trend 2$ =0.248, P=0.619). Conclusion The drug resistance in Fujian province is at a low level and shows complex and diversity. It is necessary to pay attention to the screening of drug resistance and strengthen the treatment management of drug resistant patients.

Key words: Mycobacterium tuberculosis, Drug resistance, Monitoring, Fujian province

LIN Jian, LIN Shu-fang, DAI Zhi-song, ZHAO Yong, ZHOU Yin-fa, ZHANG Tian-lin, WEI Shu-zhen. Analysis of the drug resistance surveillance results of Mycobacterium tuberculosis in Fujian Province from 2016 to 2019[J]. Chinese Journal of Antituberculosis, 2021, 43(9): 924-928. doi: 10.3969/j.issn.1000-6621.2021.09.012

Figures/Tables 3

References 11

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不同特征	总株数	总耐药(273株)				耐多药(55株)
不同特征	总株数	株数	耐药率(%)	χ²值	P值	株数	耐药率(%)	χ²值	P值
性别				0.062	0.803			3.690	0.055
男性	1116	214	19.18			37	3.32
女性	318	59	18.55			18	5.66
年龄组(岁)				2.253	0.522			2.342	0.505
≤19	48	9	18.75			3	6.25
20~39	410	73	17.80			19	4.63
40~59	541	98	18.11			20	3.70
60~97	435	93	21.38			13	2.99
职业				0.228	0.633			0.494	0.482
农民	822	160	19.46			29	3.53
其他	612	113	18.46			26	4.25
户籍				0.161	0.688			1.168	0.280
本地	1143	220	19.25			47	4.11
外地	291	53	18.21			8	2.75
治疗分类				12.419	0.000			36.775	0.000
初治	1261	223	17.68			34	2.70
复治	173	50	28.90			21	12.14

药品	初治(1261株)		复治(173株)		合计(1434株)		χ²值	P值
药品	株数	耐药率(%)	株数	耐药率(%)	株数	耐药率(%)	χ²值	P值
RFP	56	4.44	29	16.76	85	5.93	41.424	0.000
INH	91	7.22	28	16.18	119	8.30	16.080	0.000
Sm	116	9.20	26	15.03	142	9.90	5.795	0.016
EMB	26	2.06	7	4.05	33	2.30	2.664	0.103
Ofx	40	3.17	12	6.94	52	3.63	6.168	0.013
Km	13	1.03	1	0.58	14	0.98	0.323	0.570
Cm	8	0.63	3	1.73	11	0.77	2.417	0.120
PAS	6	0.48	5	2.89	11	0.77	11.650	0.001
Pto	9	0.71	0	0.00	9	0.63	1.243	0.265

耐药谱	株数	耐药率 (%)
单耐药	167	11.65
INH	38	2.65
RFP	17	1.19
Sm	68	4.74
EMB	2	0.14
Ofx	28	1.95
Km	3	0.21
Cm	5	0.35
Pto	5	0.35
PAS	1	0.07
耐多药(不含准广泛耐药、广泛耐药)	40	2.79
INH+RFP	8	0.56
INH+RFP+Sm	19	1.32
INH+RFP+EMB	5	0.35
INH+RFP+PAS	1	0.07
INH+RFP+EMB+Sm	4	0.28
INH+RFP+Sm+PAS	1	0.07
INH+RFP+EMB+Sm+PAS	2	0.14
准广泛耐药	13	0.91
INH+RFP+Ofx	2	0.14
INH+RFP+EMB+Ofx	4	0.28
INH+RFP+Sm+Ofx	2	0.14
RFP+INH+EMB+Sm+Ofx	4	0.28
INH+RFP+EMB+Sm+Km+Cm+PAS+Pto	1	0.07
广泛耐药	2	0.14
INH+RFP+Sm+Ofx+Km+Cm+PAS	1	0.07
INH+RFP+EMB+Sm+Ofx+Km+Cm+PAS	1	0.07
多耐药	51	3.56
仅含一线抗结核药品	31	2.16
RFP+Sm	3	0.21
INH+Sm	21	1.46
INH+EMB	1	0.07
RFP+EMB	1	0.07
EMB+Sm	3	0.21
RFP+EMB+Sm	2	0.14
耐药谱	株数	耐药率 (%)
含二线抗结核药品	20	1.39
RFP+Ofx	1	0.07
RFP+Pto	2	0.14
RFP+PAS	1	0.07
EMB+Km	1	0.07
Sm+Km	2	0.14
Sm+Ofx	4	0.28
Km+Cm	2	0.14
RFP+EMB+Km	1	0.07
RFP+Sm+Ofx	2	0.14
INH+Sm+Ofx	1	0.07
INH+EMB+Ofx+Cm	1	0.07
INH+Km+Pto+PAS	1	0.07
INH+Sm+Ofx+Km+PAS	1	0.07

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