Table of Content

10 August 2013, Volume 35 Issue 8

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Prevalence and risk factors of drug-resistant tuberculosis among floating population in Shenzhen

GUAN Hong-yun, YANG Ying-zhou, TAN Wei-guo, WU Qing-fang, CHE Xiao-ling

Chinese Journal of Antituberculosis. 2013, 35(8):  557-561. 

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Objective To understand the prevalence and risk factors of drug resistant tuberculosis among floating population in Shenzhen, and provide scientific evidence for TB control.  Methods Six hundred and eighty two cases of the sputum culture positive tuberculosis registered in 2010 among floating population were enrolled, the number of the initial patients and retreatment patients was 595 and 87 respectively. Species identification and drug sensitivity tests were performed, basic information were collected by questionnaire survey, multivariable logistic regression analysis was performed to determine the relevance between risk factors and drug resistance. Results Among the 682 patients enrolled in the study, the overall drug resistance rate was 17.74%（121/682）, the rates of initial and acquired drug resistance were 15.29%（91/595）and 34.48%（30/87）respectively; the overall multidrug-resistance rates were 5.87%（40/682）, 4.20%（25/595） and 17.24%（15/87）for initial and acquired multidrug-resistance respectively; the rate of the resistance to any single drug was 9.24%（63/682）; and the rate of resistance to one or more anti-tuberculosis drugs was 2.64%（18/682）. The highest drug resistance rate was from S, followed with H, R and E. The drug resistance rate of retreatment patients was significantly higher than that of the initial patients（χ²=19.15, P＜0.01）. Multivariate analysis showed that women（OR=1.623，95%CI=1.023-2.598，P＜0.05）,retreatment pulmonary tuberculosis（OR=3.648，95%CI=2.133-6.237，P＜0.01） and treatment interruption（OR=2.847，95%CI=1.718-4.718，P＜0.01）were significantly correlated to the drug resistance. Conclusion The prevalence of drug resistance tuberculosis among floating population in Shenzhen was relatively high. Women,retreatment pulmonary tuberculosis and treatment interruption were the main influencing factors associated with drug resistance.

The research on capreomycin stability in Roche medium

JIANG Yong，QIAN Ming，WANG Wei，CHEN Tao，LI Hai-cheng，CHEN Yan-mei，ZHUO Wen-ji，GUO Hui-xin，ZHOU Lin，ZHONG Qiu

Chinese Journal of Antituberculosis. 2013, 35(8):  562-565. 

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Objective To detect the stability of capreomycin (Cm) in the Roche medium, and find out the degradation rate of Cm in Roche medium and to detect the influence of Cm degradation on drug sensitive test. Methods The high performance liquid chromatograph（HPLC） test was used to detect the stability of Cm under preservation condition of 4 ℃ and 37 ℃ in Roche medium; Cm under different preservation condition was used to conduct drug sensitive test (DST) to detect the influence of Cm degradation on drug sensitive test. Results Preserved in 4 ℃, the concentration of Cm in Roche medium is inversely proportional to time, the degradation of Cm in Roche medium is close to 2.04% after 10 days, the degradation is 21.5% after 40 days, the degradation is 41.7% after 80 days, and Cm was not detected after 200 days. Preserved in 37 ℃, the degradation of Cm in Roche medium is close to 46.8% after 10 days, and Cm was not detected after 30 days. In the Cm Roche medium preserved at 4 ℃ for 10-160 days, DST results showed that in the strain which minimal inhibitory concentration (MIC) is between 0.1 to 0.2 μg/ml, 16 colonies were observed after 6 weeks in the Roche medium preserved in 4 ℃ for 40 days. In the strain which MIC is between 1.0 to 1.5 μg/ml, positive result (+) was reported after 6 weeks in the Roche medium preserved in 4 ℃ for 40 days. Conclusion Cm Roche medium is unstable when stored at 37 ℃, it should be preserved at 4 ℃ and should be used within 40 days.

Genetic polymorphisms in  VDR-TaqⅠ and  VDR-FokⅠ and susceptibility to tuberculosis among different populations in Ningxia, Peoples’Republic of China

CHEN Dan-dan, ZHU Gui-na, GUAN Guang-yu, Magda Ellis, Donald P. McManus, YANG Yu-rong

Chinese Journal of Antituberculosis. 2013, 35(8):  566-572. 

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Objective This study aimed to explore the relationship between SNP polymorphisms in TaqⅠand FokⅠ in the Vitamin D Receptor (VDR) gene and susceptibility to pulmonary tuberculosis (PTB) among the populations in Ningxia Hui Autonomous Region (NHAR), P.R. of China. Methods The confirmed 993 PTB cases (550 males and 443 females) were recruited in different TB clinics of southern NHAR in 2010, who had been diagnosed according to WHO TB-diagnosis criteria, without any other co-infections. The 880 healthy matched controls, including 485 males and 395 females were recruited to match the sex, nationality, age and residential area of the TB cases. The detection of two SNPs (TaqⅠ, FokⅠ) in the VDR gene was demonstrated by use of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. All data were entered into the SPSS 16.0 software package. The population data were tested by the Hardy-Weinberg method and then multiple logistic regression models were used for further investigation of the risk gene SNPs in different genetic models, and included covariates that had shown association with disease in the univariate analysis. The significance value was determined within 95% confidential intervals with P<0.05. Results The genotype frequencies of VDR-TT, Tt and tt were 83.0%(815/982), 15.2%(149/982), 1.8%(18/982) and 84.7%(739/872), 14.7%(128/872), 0.6%(5/872) in the case and control groups, respectively, with significant difference (χ²=6.15, P=0.046). The genotype frequencies of VDR-FF, Ff and ff were 32.4%(316/976), 47.9%(468/976), 19.7%(192/976) and 28.5%(245/861), 53.3%(459/861), 18.2%(157/861) in the case and control groups, respectively, without any significant differences between the case and control groups. The genotype frequencies in the dominant model of VDR-(TT+Tt), tt were 98.2%(964/982), 1.8% (18/982) and 99.4% (867/872), 0.6 (5/872) in the case and control groups with significantly different value (χ²=5.98, P=0.014) and an OR(95%CI) of 0.98,3.19(0.978-0.997, 1.193-8.574). The genotype frequencies in the heterozygote model of VDR-(FF+ff), Ff were 52.0%(508/976), 48.0%(468/976) and 46.7%(402/861), 53.3%(459/861) in cases and controls, with significant value (χ²=5.27, P=0.022) and an OR(95% CI) of 1.12,3.19(1.023-1.298, 0.822-0.985). Conclusion The VDR TaqⅠand FokⅠpolymorphism was associated with susceptibility to human pulmonary tuberculosis amongst Ningxia Populations. The genotype of the VDR-(FF+ff), tt showed a potential association with risk factors to human pulmonary tuberculosis in the study population groups. The genotypes of the VDR-(TT+Tt) and Ff may be associated with increased resistance to disease.

The relationship of drug susceptibility phenotype and genotype of Mycobacterium tuberculosis for rifampin and isoniozid

LIU Hou-ming, CHEN Jian-bo, XIAO Yan-yu, WU Chi, YE Fei-di, CAI Shu-hao, ZHAO Yan-min,DENG Qun-yi, SHAN Wan-shui

Chinese Journal of Antituberculosis. 2013, 35(8):  573-577. 

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Objective Analysis drug susceptibility phenotype and genotype of Mycobacterium tuberculosis (Mtb) to rifampin(RFP) and isoniozid(INH). Methods One hundred and thirty-seven morning sputum specimens were cultured for Mycobacterium tuberculosis at Shenzhen Third People’s Hospital from 2009 to 2012, Use membrane gene chip test technology to detect the mutation type of RFP and INH resistance gene, absolute concentration drug susceptibility test were performed at the same time, calculate the coincidence rate between membrane gene chip test results and the absolute concentration drug susceptibility test, to verify the accuracy of the membrane gene chip method. Results The ratio of phenotype drug-resistant for RFP and INH were 27.01(37/137) and 22.63%(31/137), the ratio of genotype drug-resistant for RFP and INH were 26.28(36/137) and 23.36%(32/137). Compared with the gold standard of absolute concentration drug susceptibility test, the membrane gene chip method for RFP displayed the sensitivity 83.78%(31/37), specificity 94.06%（95/101）,concordance 91.97% (126/137),the value of Kappa was 0.79, P<0.05;INH displayed the sensitivity 80.65%(25/31), specificity 94.29%（99/105）, concordance 90.51% (124/137),the value of Kappa was 0.73, P<0.05; the total concordances were 91.24% (250/274) for the two drugs. Conclusion The membrane gene chip susceptibility results and absolute concentration method susceptibility results are highly consistent, which is adapted for extensive application in clinical treatment, as it allows fast and accuracy detection of the resistance to RFP and INH in Mtb clinical isolates.

The clinical efficacy and safety of pulmonary tuberculosis complicated with severe pneumonia treated by linezolid

LAO Sui-hua, YU Chao-xian, CHEN Hua, XIAO Peng

Chinese Journal of Antituberculosis. 2013, 35(8):  578-580. 

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Objective To study the clinical efficacy and safety of pulmonary tuberculosis complicated with severe pneumonia treated by linezolid. Methods Fifty cases of patients with pulmonary tuberculosis complicated with severe pneumonia, who were admitted to our hospital from March, 2010 to September, 2012, diagnosed by clinical data were retrospectively analyzed, in which the efficacy by linezolid was summarized and the values in leukocyte number, neutrophil count, C-reactive protein, erythrocyte sedimentation rate, platelets and serum creatinine were compared between before and after treatment. The paired t test was used for analysis of the enumeration data, in which P<0.05 was considered statistically significance. Results In 50 patients with pulmonary tuberculosis complicated with severe pneumonia treated by linezolid, both the bacteria elimination rate and clinical cure rates were 82.0%(41/50). Their leukocyte number, neutrophil count, C-reactive protein, erythrocyte sedimentation before treatment were （14.52±6.88）×10⁹/L,（12.44±7.01）×10⁹/L，（112.28±82.59）μg/L and （66.28±37.71）mm/1h, respectively before treatment and were（9.94±3.43）×10⁹/L,（7.64±3.46）×10⁹/L，（57.19±59.23）μg/L and （50.56±27.15）mm/1h, respectively after treatment. There were significant differences between before and after treatment, in which t values were 4.214, 4.345, 3.163 and 2.098 and all P values were less than 0.05. The platelets count before treatment was（306.54±150.94）×10⁹/L and after treatment was（259.18±140.39）×10⁹/L, in which t value was 1.625, P value was 0.107; The blood creatinine concentrations were （104.88±118.54）μmol/L before treatment, （118.15±122.18）μmol/L after treatment, in which t value was －0.535, P value 0.594. No statistical differences were found between before and after treatment in platelets count and blood creatinine concentrations (all P values ＞0.05). Conclusion It is safe and effective for the patients with pulmonary tuberculosis complicated with severe pneumonia treated by linezolid, which can be used as empirical medication.

Comparative current situation of the tuberculosis infection control of health care workers between China and other countries

GENG Meng-jie,SONG Yu-dan,ZHAO Fei,GUO Hui,HU Dong-mei,LI Meng,XIONG Yong-chao,HOU Yue-yun,CHENG Jun,HE Guang-xue

Chinese Journal of Antituberculosis. 2013, 35(8):  581-586. 

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Objective Understand the relative infection control situation of tuberculosis(TB)the infection,prevalence rate of health care workers both in China and other countries，learn from the TB infection control experience in other countries and explore the advantages and disadvantages of tuberculosis infection control in China to provide theoretical basis for strengthening TB infection control of health care workers(HCW). Methods Compare and analyze the relative studies and results from the National Center for TB Control and Prevention and the thirty scientific literatures from 1995 to 2012 that retrieved from Wan-Fang database,CNKI and PubMed. Results More than a half of the health-care facilities did not conduct the standard tuberculosis infection control measures in China, the TB infection rate of health care workers was 50%-70%, the year prevalence rate was 415/100 000 to 2240/100 000, which were similar to the infection rate of 41%-72% and the year prevalence rate of 558/100 000 to 6000/100 000 in Peru,Thailand,Vietnam,Brazil these low- and middle-income countries. And higher than the infection rate of 1.2%-50% in America,Canada,Australia these high-income countries. Conclusion The infection control status in health-care facilities was poor in China, the TB infection rate and the prevalence rate of health care workers were similar to some low- and middle-income countries, but worse than the status in high-income countries, thus TB infection control needs to be reinforced in China.

Analysis of economic burden and influencing factors of non-resident pulmonary tuberculosis patients in Putuo district, Shanghai

ZHENG Yi-hui, DENG Hai-ju, CHEN Jun, LIU Yan, ZHANG Yu-yan, XU Biao

Chinese Journal of Antituberculosis. 2013, 35(8):  587-591. 

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Objective  To understand the medical care economic burden of non-resident new pulmonary tuberculosis (TB) patients and its influencing factors in Putuo district, Shanghai. Methods  A retrospective study was conducted in rural-to-urban migrant tuberculosis patients who were diagnosed in 2008 and completed the treatment at the time of investigation. Information on the situation of individuals and families living with TB and patients’ direct medical expenses for TB diagnosis and treatment were extracted from questionnaire investigation. Ninety-seven pieces of 105 pieces questionnaires were collected and were valid. Medical records and data of reports were reviewed to check the information about patients’ background, the items of diagnostic tests, medications, and related expenses. Data were analyzed by SPSS 15.0 to describe patients’ household income and expenses in 2008, medical cost for TB diagnosis and treatment and the proportion of treatment cost from annual household income, and the medical cost and the proportion among different patients were compared. 0.05 was set as the criteria for statistically significant difference.  Results  The average medical expenses of TB care was 5177 Yuan per capita, accounting for 16.29% of the annual household income; of which 2452 Yuan was direct medical expenses, accounting for 8.23% of the income. The average medical expenses of TB care of male and female patients were 3174 Yuan and 1840 Yuan, which accounted for 9.92% and 5.94% of the annual family income respectively. The differences of average cost (Z=－1.722，P=0.085) and the proportion (Z=－1.664，P=0.096) between male and female were not significant. The average costs of TB care of patients with primary school education and lower, junior middle school, senior middle school and/or technical secondary school, and junior college and above were 3634 Yuan, 3109 Yuan, 1997 Yuan and 1745 Yuan respectively, of which the difference was not significant (χ²=4.094，P=0.251), while the proportions of treatment cost from annual household income of patients with different education level were 10.50%, 9.92%, 9.61% and 3.79% respectively, which were significantly different (χ²=9.225，P=0.026). The average medical expenses of TB care of patients with medical insurance, without medical insurance and unaware of insurance situation were 2765 Yuan, 1943 Yuan and 6115 Yuan respectively, of which the difference were significant (χ²=8.218，P=0.016), while the proportions of treatment cost from annual household income of patients with different medical insurance were 8.22%, 7.61% and 17.60% respectively, without significant difference (χ²=3.777，P=0.151). The average costs of TB care of smear positive and negative patients were 2046 Yuan and 3078 Yuan, which accounted for 7.69% and 8.50% of the annual household income respectively. The differences of average cost (Z=－0.685，P=0.493) and the proportion (Z=－0.094，P=0.925) between the positive and negative cases were not significant. The average medical expenses of TB care of in-patients and out-patients were 21 001 Yuan and 1988 Yuan, with the proportions of 54.99% and 7.27% of the annual family income respectively. The difference of average cost (Z=－5.233，P<0.001) and the proportion (Z=－4.392，P<0.001) between these two types of patients were significant. Conclusion  The non-resident TB patients in Putuo district are the focus group for TB control and prevention. TB diagnosis and treatment brings heavy economic burden on non-resident TB patients. The patients having been hospitalized during treatment, with lower education and without medical insurance have higher economic burden than others. It is imperative to implement pro-poor support policies to reduce the economic burden for effective TB control.

The clinical research on treating encapsulated tuberculous pleural effusion with the method of reconciliation and diuresis

LI Tong-xia，HAN Tong-liang，XUE Wei-lin，HU Hai-bo，DENG Kai，SU Hai-tao

Chinese Journal of Antituberculosis. 2013, 35(8):  592-596. 

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Objective  To investigated the clinical efficacy with the method of reconciliation and diuresis on encapsulated tuberculous pleural effusion.   Methods  We randomly divided 120 participants, which were diagnosed as encapsulated tuberculous pleural effusion, into 2 groups(the treatment group and the control). Before and after treatments, we observed the levels of TNF-α in pleural effusion. The pleural thickness was measured before and at the end of the first,the third and the ninth months after treatments. The comprehensive curative effect was evaluated at the third and the ninth months after treatment.  Results  There was significant difference in the levels of TNF-α in pleural effusion between 2 groups（t=－3.114, P<0.01), which were (35.35±17.46) pg/L and (47.16±18.89) pg/L in treatment group and the control, respectively. The pleural thickness measured on CT between 2 groups was statistically significant difference at the different month after treatment(F=42.727，P=0.000)，which were (0.42±0.27) cm、(0.31±0.26) cm、(0.25±0.21) cm at the first，third and ninth months after treatments in treatment group, respectively and were (0.54±0.30) cm、(0.42±0.32) cm、(0.37±0.28) cm at the same months after treatments in control group, respectively. While compared comprehensively efficacy between 2 groups, comprehensive improvement was more significant in the treatment group (70.69%, 41/58; 89.66%, 52/58) at the the third and ninth months after the treatments(Z=－2.856 and －3.192 respectively,both of P＜0.05), than that of in the control group (45.00%, 27/60; 65.00%, 39/60). Conclusion  The method of reconciliation and diuresis combined with antituberculosis drugs to treat encapsulated tuberculous pleural effusion is better than the method with antituberculosis drugs only. It can reduce pleural adhesion and the levels of TNF-α in pleural effusion.

The comparative study of risk factors between patients with tuberculous pleural effusion and malignant pleural effusion

XU De-xiang，XU Feng，SONG Li-li

Chinese Journal of Antituberculosis. 2013, 35(8):  597-600. 

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Objective  To explore the differences of risk factors between patients with tuberculous pleural effusion and malignant pleural effusion and to provide basis of clinical diagnosis of pleural effusion. Methods  We consecutively enrolled the 264 patients who was diagnosed of tuberculous pleural effusion or malignant pleural effusion in January 2006—December 2012 in respiratory department of the 2nd Affiliated Hospital of Qingdao University, of which 147 cases were tuberculous pleural effusion and 117 cases were malignant pleural effusion. We compared the patients’ age, gender, whether with diabetes, respiratory disease history, the economic status, work tired feeling, group living behavior, lack of exercise, eating regularity, sleep time, psychological stress, smoking index, disease family history between the 2 groups.The univariate and multivariate logistic regression analysis was made on the risk factor for morbidity of tuberculous pleural effusion and malignant pleural effusion.  Results  The univariate results showed that diabetes mellitus［15.0% (22/147) vs 6.8% (8/117), χ²=4.571, P=0.034］, low economic status［38.1% (56/147) vs 29.9% (35/117),χ²=5.103, P=0.028］, with group living behavior［29.3% (43/147) vs 9.4% (11/117),χ²=4.977, P=0.030］, are risk factors for tuberculous pleural effusion; Age >40 years［45.6% (67/147) vs 78.6% (92/117),χ²=4.752, P=0.032］, high degree of psychological stress［15.0% (22/147) vs 33.3% (39/117),χ²=6.031, P=0.017］, smoking index >400［25.9% (38/147) vs 32.5% (38/117), χ²=5.228, P=0.024］, and with family history of similar disease［9.5% (14/147) vs 34.2% (40/117), χ²=3.976, P=0.046］ are risk factors for malignant pleural effusion. After the exclusion of other factors, diabetes mellitus (χ²=5.391, P=0.027, OR=2.457,95%CI: 5.051-1.773) and group living behavior (χ²=5.491, P=0.022, OR=3.636, 95%CI: 6.494-2.584) are still risk factors for tuberculous pleural effusion; aged >40 years (χ²=5.364, P=0.022, OR=2.323,95%CI: 1.197-2.588) and with family history of similar disease(χ²=5.897, P=0.021, OR=3.080,95%CI: 2.233-4.018) are risk factors for malignant pleural effusions. Conclusion  Pleural effusion in patients with diabetes mellitus or with group living behaviors are more prone to have tuberculous pleural effusion, and if patients age more than 40 years or have a family history of similar disease, are more prone to have malignant pleural effusion.

Effect of nursing intervention on health education in patients with tuberculous destroyed lung who received surgery

ZENG Hua-zhi，LIU Hong-tao，YE Min-tao，ZHANG Ling，TAO Shu，WEN Wen-pei，HUANG Dong-sheng

Chinese Journal of Antituberculosis. 2013, 35(8):  601-605. 

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Objective  To explore the methods of health education in patients with tuberculous destroyed lung who received surgery. Methods  One hundred patients with tuberculous destroyed lung who received surgery in our hospital from June 2010 to March 2013 were randomly divided into experimental group and control group according to admission time. We designed nursing clinical pathway for the experimental group. Fifty patients in the experimental group received health education by clinical pathway according to the patient’s specific clinical symptoms and care needs, and the patients in control group received routine care health education. The effects of health education in 2 groups were compared. SPSS 11.0 software was used for data analysis, χ² test was applied to compare the difference of awareness rate and t test was applied to compare the difference of score of health behavior. P<0.05 was set for statistical difference.  Results  The awareness rates of patients in experimental group on 4 preoperative examination knowledge points（86.5%，173/200）, 6 preoperative preparation knowledge points（82.3%，247/300）, 3 postoperative analgesia knowledge points（80.7%，121/150）, 1 postoperative pipeline manage knowledge point（82.0%，41/50）, 1 knowledge point（82.0%，41/50） on diet and nutrition and 4 postoperative rehabilitation knowledge points（82.0%，164/200）were significantly higher than the control group(78.0%,156/200; 58.7%,176/300; 54.7%,82/150; 56.0%,28/50; 62.0%,31/50; 57.0%,114/200 respectively）(χ² values were 4.95, 40.397, 23.17, 7.901, 4.96 and 29.48 respectively, P<0.05）. And there was no significant difference of diseaserelated knowledge awareness between 2 groups (χ²＝2.953, P>0.05）. There were more changes in health behavior in experimental group than control group［(11.34±1.17) vs (10.38±1.64）］ (t=4.13, P<0.05）.  Conclusion  Establishing nursing clinical pathway for patients with tuberculous destroyed lung who received surgery can provide comprehensive and effective professional guidance for nurses, improve the effect of health education and help patients recover quickly.

The study on the case-finding model of pulmonary tuberculosis in Shenzhen jail

GUAN Hong-yun, YANG Ying-zhou, TAN Wei-guo, WU Qing-fang, CHE Xiao-ling

Chinese Journal of Antituberculosis. 2013, 35(8):  606-608. 

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Objective  To explore a right way of case-finding of tuberculosis in prison. Methods  Information of tuberculosis patients（155 cases）registered in prison from 2009 to 2012 was collected and the case-finding ways including entry screening, medical treatment due to disease and the annual census were analyzed. Results  Among the 155 active pulmonary tuberculosis cases registered from 2009 to 2012, 79 (51.0%) cases were detected from entry screening, which was the primary case-finding way in prison, 43 (27.7%) cases were found during annual census, and 33 (21.3%) cases were found by medical treatment due to disease. Among the 43 cases which were detected from annual census, 22 （51.2%） cases were asymptomatic.   Conclusion  The combination of different tuberculosis case-finding modes provides a way of finding tuberculosis cases more thoroughly and in time, which avoids TB transmission in prison.

The analysis of tuberculosis epidemic situation and the effect of control program in Quanzhou, Fujian

CHENG Yu-mei，RUAN Xiang-zhao，ZENG Xiao-rong，LIAO Bao-lan

Chinese Journal of Antituberculosis. 2013, 35(8):  609-614. 

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Objective  To evaluate the tuberculosis epidemic situation and the effect of control program in Quanzhou city.  Methods  This is a retrospective survey, we made the comparison of new smear positive pulmonary tuberculosis (PTB) registration rate and treatment outcome between the first decade (1992—2011) and second decade (2002—2011) of implementation of world bank tuberculosis control project. A total of 30491 cases were registered. We made the drug susceptibility test for 3532 new culture-positive outpatient and inpatient registered between 1991 and 2005, taking every 3 years as a phase, and analyzed the resistance rates of the 5 phases.  Results  Between 1992 and 2001, a total of 7016 cases of new smear-positive tuberculosis were registered with the average registration rate of 11.4/100000（7016/630050）. In contrast, after the project implementation between 2002 and 2011, 23475 cases were registered with the registration rate of 30.37/100000（23475/772870）which increased 2.73 times compared with before the project. The male registration rate was 2.75 times higher than that of female. Patients aged between 15-54 accounted for 74.19%（22622/304910）；majority of patients were farmers, accounting for 50.57% (15419/30491); geographical distributed mainly along the coast, accounting for 72.29% (22958/30491), the cure rate was 86.61% (26409/30491). Within the 15 years, the initial drug resistance rate decreased from 27.66% (135/488) in 1991-1993 to 10.62% (77/725) in 2003-2005 with the decreasing rate of 61.61%［(27.66-10.62)/27.66］. Conclusion  The control effect of tuberculosis is remarkable. And in the future we should target the young adults and floating population, improve the quality of DOTS and control the generation of drug resistant TB.

Advances in reseach on Mycobacterium tuberculosis drug resistance mechanism

DING Hai-rong, QIN Chuan, ZHAN Ling-jun

Chinese Journal of Antituberculosis. 2013, 35(8):  615-620. 

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Tuberculosis was one of most serious infectious diseases that were harmful to human health. Antibiotics was effective treatment against this bacterium. But the emergency of multi- and extensively drug-resistant Mycobacterium tuberculosis(Mtb) were occurred frequently when the use of antibiotics was unproper. Drugresistant phenotype was due to mutations in drug resistant related genes, this paper will state the progress in mechanism study of drug resistant Mtb, which will guide the diagnosis and treatment of drug resistant Mtb.