Table of Content

10 September 2022, Volume 44 Issue 9

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Guideline·Standard·Consensus

Expert consensus on diagnosis and treatment of latent tuberculosis infection in patients with rheumatic diseases

National Clinical Research Centre for Infectious Disease/The Third People’s Hospital of Shenzhen, Peking University Shenzhen Hospital, Peking Union Medical College Hospital of Chinese Academy of Medical Sciences, Chinese Antituberculosis Association, Editorial Board of Chinese Journal of Antituberculosis, Shenzhen Key Laboratory of Inflammatory and Immune Diseases

Chinese Journal of Antituberculosis. 2022, 44(9):  869-879.  doi:10.19982/j.issn.1000-6621.20220225

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Rheumatic diseases are autoimmune diseases that occur when an individual’s immune system mistakenly attacks healthy tissues, and are often treated with glucocorticoids, immunosuppressants, biological agents, and small-molecule targeted drugs, etc., which can lead to an increased risk of other autoimmune dysfunctions in patients and the activation of latent tuberculosis infection (LTBI). Therefore, LTBI screening in clinical is essential for patients with rheumatic diseases who meet the screening criteria. This requires greater collaboration and awareness between rheumatologists and tuberculosis physicians, to conduct scientific assessment for patients with rheumatic diseases who need LTBI screening, and to develop preventive treatment guidelines to prevent patients with rheumatic diseases from developing active tuberculosis after LTBI. Therefore, the National Clinical Research Centre for Infectious Disease/The Third People’s Hospital of Shenzhen, Peking University Shenzhen Hospital, Peking Union Medical College Hospital of Chinese Academy of Medical Sciences, Chinese Antituberculosis Association, Editorial Board of Chinese Journal of Antituberculosis and Shenzhen Key Laboratory of Inflammatory and Immune Diseases joint effort in the publication of an expert consensus on the diagnosis and treatment of LTBI in patients with rheumatic diseases. This consensus is based on the epidemiology, evidence-based medicine, and clinical research of rheumatic diseases complicated with LTBI, and has been discussed for many times and reached consensus. It can serve as a reference.

Expert consensus on ultrasound diagnosis, classification and interventional therapy of tuberculous pleurisy (2022 Edition)

Ultrasound Professional Committee of Tuberculosis Branch of Chinese Medical Association, Interventional Ultrasound Professional Committee of Interventional Physician Branch of Chinese Medical Doctor Association Danwei

Chinese Journal of Antituberculosis. 2022, 44(9):  880-897.  doi:10.19982/j.issn.1000-6621.20220257

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Tuberculous pleurisy is pleural inflammation caused by delayed hypersensitivity response when Mycobacterium tuberculosis invades the pleural cavity. It is a kind of pulmonary tuberculosis, which is considered to be one of the main causes of exudative pleural effusion in clinic. Without timely and effective diagnosis or treatment, tuberculous pleurisy can lead to severe ventilatory dysfunction and pulmonary function damage. At present, chest ultrasound is the preferred imaging method for the diagnosis and evaluation of tuberculous pleurisy. One of the diagnostic criteria of tuberculous pleurisy is to obtain positive etiology or positive histopathology through ultrasound-guided pleural puncture biopsy. Classification and corresponding treatment of tuberculous pleurisy according to different ultrasound images can effectively improve the cure rate, reduce adverse complications and reduce the recurrence rate. Due to the differences in examination methods, diagnostic results and treatment between different hospitals and examiners, it is not conducive to the comprehensive management of patients with tuberculous pleurisy. Therefore, this consensus introduces ultrasound-guided pleural puncture biopsy, ultrasound classification of tuberculous pleurisy and clinical treatment of different types, aiming to provide precise, standardized and rational ultrasound diagnosis and treatment for tuberculous pleurisy patients at different stages.

Expert Note

Pathological types and characteristics of experimental pulmonary tuberculosis

Bao Rong, Gao Jianfeng, Rao Yan

Chinese Journal of Antituberculosis. 2022, 44(9):  898-905.  doi:10.19982/j.issn.1000-6621.20220134

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Experimental pulmonary tuberculosis is different from clinical pulmonary tuberculosis and its pathological changes have its own characteristics. Pathology tuberculosis from animal models are varied. The differences in laboratory animal species and strain, tuberculosis strain, infection dose and challenge route result in great differences in pathology, and the related research results are inconsistent. This article summarizes experimental pulmonary tuberculosis, including animal model, its occurrence and development, lesion type, scoring of tuberculosis lesion and effectiveness evaluation of anti-tuberculosis drugs and vaccines, especially the perivasculitis/periangitis and peribronchiolitis in very early stage after tuberculosis infection. The pathological characteristics of pulmonary tuberculosis in multiple experimental animals are illustrated, such as mice, guinea pigs, goats and non-human primates. A new classification method is proposed in this article according to the characteristics of the subsequent pathological lesion after tuberculosis infection and these types consist of not only nodules, necrosis, tuberculous pneumonia, cavities and calcification/mineralization, but also lung abscess, emphysema, lung congestion, etc. Interstitial pneumonia (interstitial fibrosis) are also included as the lesion types of experimental pulmonary tuberculosis.

Original Articles

3HP regimen in the treatment of rheumatic diseases complicated with Mycobacterium tuberculosis latent infection:a prospective study

Wang Yuxiang, Chen Qiuqi, Yu Xinxin, Zhan Senlin, Zhang Peize, Deng Guofang

Chinese Journal of Antituberculosis. 2022, 44(9):  906-910.  doi:10.19982/j.issn.1000-6621.20220238

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Objective: To evaluate the safety and completion rate of 3HP regimen (isoniazid plus rifapentine; Each 0.9 g/time, once a week, 12 times) in the treatment of rheumatic diseases complicated with Mycobacterium tuberculosis latent infection (LTBI). Methods: Using a prospective study approach,38 patients with rheumatic disease complicated by LTBI,were prospectively enrolled from June to December 2019 in the Third People’s Hospital of Shenzhen. 3HP regimen was used for preventive therapy and completion rate, adverse events were recorded. All participants were followed up for 2 years of active tuberculosis. Results: The incidence of adverse events in patients treated with 3HP regimen was 15.8% (6/38), including 2 cases (5.3%) of gastrointestinal reactions, 1 case (2.6%) of insomnia, dizziness, rash and drug-induced hepatitis respectively. One participant ceased tuberculosis preventive therapy due to drug-induced hepatitis. The completion rate was 97.4% (37/38). No active tuberculosis was observed during 2 years of follow-up. Conclusion: 3HP regimen has good safety and high completion rate in the prophylactic treatment of patients with rheumatic diseases complicated with LTBI. The efficacy of 3HP regimen in the prevention of active tuberculosis still needs to be further evaluated.

Analysis of clinical features and peripheral lymphocyte subsets of systemic lupus erythematosus patients complicated with tuberculosis infection

Xie Jingyi, Zou Ruifeng, Chen Yulan, Chen Yong, Liu Dongzhou, Hong Xiaoping

Chinese Journal of Antituberculosis. 2022, 44(9):  911-916.  doi:10.19982/j.issn.1000-6621.20220240

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Objective: To investigate the clinical features and characteristics of peripheral blood lymphocyte subsets in systemic lupus erythematosus (SLE) patients complicated with tuberculosis infection. Methods: A retrospective study was conducted in 287 SLE patients who were admitted to Shenzhen People’s Hospital and completed the interferon-gamma release assays and lymphocyte subset detection from January 2015 to December 2021. Among them, 30 cases complicated with active tuberculosis, and 16 cases complicated with latent tuberculosis infection (LTBI). According to the ratio of 1∶2 in the group of SLE complicated with active tuberculosis, 60 patients with SLE not infected with Mycobacterium tuberculosis or other pathogens in the same period were selected as the uninfected group. Meanwhile, 40 healthy volunteers who matched the gender and age of the SLE patients complicated with active tuberculosis and completed the detection of lymphocyte subsets from the health screen center of our hospital were selected as the control group. The clinical features, laboratory test results and clinical treatment were collected and analyzed. Results: The duration of tuberculosis in active tuberculosis group was 4.0 (1.0, 8.0) weeks, and mainly complicated with pulmonary tuberculosis alone (17 cases, 56.7%). The duration of SLE in the active tuberculosis group was 54.0 (7.5, 96.0) months, which was significantly shorter than that of the LTBI group (96.0 (72.0, 180.0) months; Z=-2.832, P=0.005), and the proportion of interstitial pneumonia (7 cases, 23.3%) was significantly higher than that in the LTBI group (0.0%; χ²=4.403, P=0.036). Compared with the uninfected group, CD3⁺ T cell count ((766±480) cells/μl vs. (1146±636) cells/μl), CD4⁺ T cell count ((370±278) cells/μl vs. (517±291) cells/μl) and CD8⁺ T cell counts (376 (244, 421) cells/μl vs. 420 (322, 742) cells/μl) in tuberculosis group were significantly decreased, and the difference was statistically significant (t=-2.875, P=0.005; t=-2.298, P=0.024; Z=-2.842, P=0.004, respectively). There was no significant difference in the proportion of lymphocyte subsets in the three groups of SLE patients. Conclusion: Tuberculosis infection in SLE patients were mainly in the lungs. The incidence of interstitial pneumonia in SLE patients complicated with active tuberculosis was higher. In clinical treatment, if there is a decrease in T lymphocytes in SLE patients, especially when CD8⁺ T cells are significantly decreased, we should be alert whether complicated with tuberculosis infection.

Efficacy and safety of recombinant Mycobacterium tuberculosis fusion proteins (EC) for the diagnosis of Mycobacterium tuberculosis infection: A system review

Cheng Xiao, Chen Zhe, Jiao Xuefeng, Yang Nan, Diao Sha, Ni Xiaofeng, Liu Zheng, He Siyi, Zeng Linan, Wan Chaomin, Kang Deying, Wu Bin, Ying Binwu, Zhang Hui, Zhao Rongsheng, Zhang Lingli

Chinese Journal of Antituberculosis. 2022, 44(9):  917-926.  doi:10.19982/j.issn.1000-6621.20220253

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Objective: Compared with purified protein derivative of tuberculin (TB-PPD), to systematically evaluate the efficacy and safety of recombinant Mycobacterium tuberculosis fusion protein (EC) in the diagnosis of Mycobacterium tuberculosis (MTB) infection. Methods: Data were searched from the clinical guideline database, biomedical literature database, official websites of health administrative departments and industry associations, and official websites of adverse reaction monitoring. The retrieval time is from the time of building the database to February 2022. English search terms were recombinant Mycobacterium tuberculosis fusion protein and CFP10/ESAT6; Chinese search terms were recombinant Mycobacterium tuberculosis fusion protein, Yika, and CFP10/ESAT6. Guidelines, consensuses, group standards, systematic reviews, and original studies on the efficacy and safety of recombinant Mycobacterium tuberculosis fusion protein (EC) and TB-PPD in diagnosing MTB infection were collected. Two investigators independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis or descriptive analysis were used according to the size of heterogeneity. Results: Two guidelines, three expert consensus papers, and two group standards were included, and all presented that both recombinant Mycobacterium tuberculosis fusion protein (EC) and TB-PPD could be used for the detection of MTB infection and tuberculosis. One systematic review was included, and the results showed that the recombinant Mycobacterium tuberculosis fusion protein (EC) skin test recruited a total of 887 participants, with the sensitivity of 86.06% (95%CI: 82.39%-89.07%). The four original studies included were randomized controlled trials. The effectiveness meta-analysis showed that, regardless of the population, the sensitivity (89.3% vs. 90.4%) and negative likelihood ratio (0.177 vs. 0.220) of recombinant Mycobacterium tuberculosis fusion protein (EC) and TB-PPD were not significantly different. The specificity (85.5% vs. 47.3%), diagnostic odds ratio (42.238 vs. 8.040), positive likelihood ratio (6.048 vs. 1.710), positive predictive value (66.0% vs. 35.1%) and negative predictive value (96.2% vs. 94.0%) of recombinant Mycobacterium tuberculosis fusion protein (EC) were significantly better than those of TB-PPD. The safety results showed that the adverse events of recombinant Mycobacterium tuberculosis fusion protein (EC) and TB-PPD were just local itching and pain, and no serious adverse events occurred. Conclusion: Recombinant Mycobacterium tuberculosis fusion protein (EC) can be used for the diagnosis of MTB infection and auxiliary diagnosis of tuberculosis, and has better efficacy when compared with TB-PPD.

Implementation study on promoting the use of anti-tuberculosis fixed-dose combination in provincial and prefecture tuberculosis designated hospitals

Wang Ni, Huang Fei, Zhu Limei, Zeng Yi, Zhang Ruimei, Geng Hong, Liu Xuefa, Zheng Jiangang, Zong Peilan, Zeng Zhong, Li Jinlan, Cai Cui, Guo Xiaohong, Zhong Yin, Liu Li, Xie Yan, Du Fangfang, Zhou Lin, Cheng Shiming

Chinese Journal of Antituberculosis. 2022, 44(9):  927-933.  doi:10.19982/j.issn.1000-6621.20220145

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Objective: To evaluate the feasibility of the use of anti-tuberculosis (TB) fixed dose combination (FDC) in provincial and prefecture TB designated hospitals under the national TB programme. Methods: According to the typical sampling methods, we selected 5 provinces, and one provincial and one prefecture TB designated hospital were determined in each of the provinces. The observational study method was adopted and the newly diagnosed tuberculosis patients who are rifampicin sensitive or without drug resistance test results were included. According to the inclusion and exclusion criteria, to analyze the inclusion and withdrawal of the patients. Results: A total of 3558 pulmonary TB patients were registered from April 1. to July 31, 2021. The inclusion rate was 71.9% (2559/3558), from 45.6% (215/472) to 94.5% (346/366). 12.1% (431/3558) patients who did not use FDC due to contraindications. The proportion of patients with contraindications in the number of registered patients was from 2.3% (5/215) to 43.9% (207/472). 22.3% (571/2559) stopped using FDC in the middle of the treatment, from 3.6% (13/365) to 44.8% (155/346). 54.5% (311/571) were stopped due to adverse reactions, the proportion of patients with adverse reactions and withdrawal from the group among patients using FDC was from 0.3% (1/300) to 27.2% (94/346). The withdrawal rate was 7.9% (203/2559) at the end of the first month of treatment, and 0.4% (8/1996) at the end of the six month of treatment. The withdrawal rate decreased significantly with the course of treatment ($\chi _{\text{trend}}^{2}$=14.277,P<0.05). Conclusion: FDC is feasible for use at provincial and prefecture TB designated hospitals. Strengthen the training of medical staff is the key to further improve the usage of FDC and could also reduce the treatment interruption.

Application value of volume CT value inquantifying the activity of pulmonary tuberculosis lesions above 5 mm

Wei Ganhui, Zhang Jiacheng, Qiu Xiaowei

Chinese Journal of Antituberculosis. 2022, 44(9):  934-939.  doi:10.19982/j.issn.1000-6621.20220104

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Objective: To explore the auxiliary diagnostic value of volume CT value in quantifying the activity of pulmonary tuberculosis. Methods: A total of 224 patients with clinically confirmed pulmonary tuberculosis from January 2013 to May 2017 in the Department of Tuberculosis, Hangzhou Chest Hospital, Medical College of Zhejiang University were selected.And 216 active tuberculosis lesions and 128 inactive tuberculosis lesions were included according to the standard of that the shortest diameter line on the mediastinal window >5 mm.ITK-SNAP software was used to manually segment lesion images, calculate CT values of lesion volume, and analysis the ROC curve.Based on the final clinical diagnosis, the auxiliary diagnostic efficacy and consistency of the conventional CT reading method and the volume CT values in determining the activity of pulmonary tuberculosis were compared. Results: The volume CT value of 216 active pulmonary tuberculosis lesions was significantly lower than that of 128 inactive pulmonary tuberculosis lesions (32.38 (28.17, 36.23) HU vs. 78.89 (57.78, 120.27) HU, Z=-15.439, P<0.001). ROC curve analysis showed that, when the maximum value of Youden index was 0.958, the best critical value was 45.79 HU, the sensitivity and specificity of volume CT value in judging active pulmonary tuberculosis were 96.3% and 100.0%, with a maximum area under the AUC curve of 0.998. Taking the final clinical diagnosis as the reference standard, the sensitivity, specificity, accuracy and Kappa value of the conventional CT reading method to determine the activity of pulmonary tuberculosis were 71.8%(155/216), 71.1%(91/128), 71.5% (246/344)and 0.413, respectively; while those of volume CT value were 96.3%(208/216), 100.0%(128/128), 97.7%(336/344) and 0.951, respectively. Conclusion: By measuring the volume of pulmonary tuberculosis lesions, CT value can accurately quantify the activity of pulmonary tuberculosis, which is of very important auxiliary diagnostic value.

Analysis of drug resistance situation of Mycobacterium tuberculosis strains from 231 spinal tuberculosis patients

Wang Chaohong, Sun Qing, Liao Xinlei, Yan Jun, Wang Chenqian, Jiang Guanglu, Wang Fen, Xue Yi, Huang Hairong, Wang Guirong

Chinese Journal of Antituberculosis. 2022, 44(9):  940-946.  doi:10.19982/j.issn.1000-6621.20220178

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Objective: To analyze the drug resistance characteristics of 231 patients with spinal tuberculosis and to provide reference for clinicians to develop proper treatment regimens for spinal tuberculosis patients. Methods: The Mycobacterium tuberculosis strains and clinical data were collected from 231 culture-positive spinal tuberculosis patients, who were hospitalized in Beijing Chest Hospital from January 2016 to December 2021. Drug susceptibility test was performed for the following 16 drugs using ENCODE microplate methods: streptomycin (Sm), isoniazid (INH), rifampicin (RFP), ethambutol (EMB), rifapentine (Rft), levofloxacin (Lfx), amikacin (Am), capreomycin (Cm), prothionamide (Pto), isoniazid aminosalicylate (Pa), moxifloxacin (Mfx), p-aminosalicylic acid (PAS), clarithromycin (Clr), rifabutin (Rfb), kanamycin (Km) and clofazimine (Cfz). Results: The total drug resistance rate of those spinal tuberculosis patients to at least one of the 16 drugs was 34.63% (80/231), of which the drug resistance rate was significantly higher in previously treated patients (75.44%, 43/57) than in new patients (21.26%, 37/174), and the difference was statistically significant (χ²=55.660, P<0.001). The drug resistance rates of spinal tuberculosis patients to the 16 drugs from high to low were: Sm (24.68%, 57/231)>INH (22.51%, 52/231)>Rft (19.05%, 44/231)>RFP (18.18%, 42/231)>Pa (15.58%, 36/231)>Rfb (13.85%, 32/231)>Lfx (7.79%, 18/231)>PAS (7.36%, 17/231)>Cm (5.63%, 13/231)>Km (4.76%, 11/231)=Cfz (4.76%, 11/231)>Pto (4.33%, 10/231)=Clr (4.33%, 10/231)>EMB (3.90%, 9/231)>Am (3.46%, 8/231)>Mfx (2.60%, 6/231). The poly-drug resistance rate of spinal tuberculosis patients was 11.69% (27/231), of which the poly-drug resistance rate was significantly higher in previously treated patients (19.30%, 11/57) than in new patients (9.20%, 16/174),and the difference was statistically significant (χ²=4.246, P=0.039); The multidrug-resistance rate was 15.58% (36/231), of which the multidrug-resistance rate was significantly higher in previously treated patients (52.63%, 30/57) than in new patients (3.45%, 6/174),and the difference was statistically significant (χ²=46.980, P<0.001). Conclusion: There was serious epidemic of drug resistance in spinal tuberculosis patients. Effective treatment regimens should be developed according to the results of drug susceptibility tests.

Analysis of spatial distribution characteristics of pulmonary tuberculosis cases in Hefei City, 2009—2020

Nie Tingyue, Chen Wei, Zhang Jieying, Cao Hong, Qian Bing, Gu Yingqiang, Liu Xuxiang

Chinese Journal of Antituberculosis. 2022, 44(9):  947-953.  doi:10.19982/j.issn.1000-6621.20220159

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Objective: To analyze the spatial distribution characteristics of pulmonary tuberculosis (PTB) cases in Hefei City from 2009 to 2020. Methods: The information of 42681 PTB patients who were recorded in The TB Management Information System (a sub-system of the China Disease Prevention and Control Information System) in Hefei City from 2009 to 2020 was obtained. A case spatial distribution map of the street/township level was drawn with GeoDa and Arcgis 10.8 spatial analysis software, to explore the spatial distribution pattern and cold/hot spot areas of PTB. Results: A total of 42681 PTB cases were notified in Hefei City from 2009 to 2020, the incidence decreased from 57.96/100000 (4195/7237966) in 2009 to 31.04/100000 (2908/9369881) in 2020 and showed a fluctuating decreasing trend ($\chi _{\text{trend}}^{2}$=12.531,P<0.001). The result of global spatial autocorrelation analysis showed that there was spatial autocorrelation of PTB incidence in Hefei City from 2009 to 2014, the Moran’s I values were all greater than 0, P values were all <0.05. The spatial distribution from 2015 to 2020 trended to be random. Local autocorrelation analysis showed that the high-high clustered incidences were mainly concentrated in Changfeng County and Feidong County. Low-low clustered areas were mainly concentrated in the main urban areas (Luyang District, Baohe District). The analysis of cold/hot spot showed that there were two hot spots, which were distributed in Yijing township of Changfeng County and Yandian Township of Feixi County. Conclusion: The PTB epidemic in Hefei City has a certain degree of aggregation, so different prevention and control measures should be taken according to characteristics of different counties, districts, streets and towns, and the prevention and control efforts should be strengthened in the high-high clustered streets and hot spot areas.

Review Articles

The research progress of the reactivation of latent tuberculosis infection in patients with rheumatic diseases

Wu Wenqi, Zhong Jianqiu, He Juan, Deng Guofang, Wang Qingwen

Chinese Journal of Antituberculosis. 2022, 44(9):  954-959.  doi:10.19982/j.issn.1000-6621.20220243

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Rheumatic diseases are a group of autoimmune and inflammatory diseases characterized by disorders of the immune system, while with the application of various immunosuppressants and biological agents in rheumatic diseases, the immune state of the body has been greatly altered, increasing the risk of activation of latent tuberculosis infection. To better understand the activation mechanism of latent tuberculosis infection in patients with rheumatic diseases and reduce the incidence and mortality, the immune response mechanisms of tuberculosis infection, the activation mechanism of latent tuberculosis infection with rheumatic diseases, and the therapeutic drugs that increase the risk of activation are reviewed for reference.

Recent advances in treatment of latent tuberculosis infection complicated with rheumatic diseases

Chen Qiuqi, Han Tingting, Wang Qingwen, Deng Guofang

Chinese Journal of Antituberculosis. 2022, 44(9):  960-965.  doi:10.19982/j.issn.1000-6621.20220236

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With the use of glucocorticoids, immunosuppressants, biological agents, and small-molecule targeted drugs in patients with rheumatic diseases, the activation of latent tuberculosis infection gradually increased which has become an important front for controlling tuberculosis epidemic. To provide a reference for clinical diagnosis and treatment, this review summarizes the research progress in the epidemiology, diagnostic methods, risk factors, screening strategies and treatment of rheumatic diseases complicated with latent tuberculosis infection.

The risk of tuberculosis infection with non-tumor necrosis factor-targeted drugs in the treatment of rheumatoid arthritis

Han Xu, Guan Shangqi, Shi Yinpeng, Mei Yifang

Chinese Journal of Antituberculosis. 2022, 44(9):  966-972.  doi:10.19982/j.issn.1000-6621.20220242

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Rheumatoid arthritis (RA) is a common chronic, inflammatory autoimmune disease. Over the years, the application of tumor necrosis factor inhibitors (TNFi) has brought epoch-making progress to the treatment of RA, but its adverse risk, especially the significantly increased incidence of active tuberculosis, has attracted more and more attention. Recently, non-tumor necrosis factor (TNF)-targeted drugs have achieved good efficacy in the treatment of RA, more and more studies have shown that it caused the risk of active tuberculosis is lower than that of TNFi. This article will discuss the risk of tuberculosis infection with non-TNF-targeted drugs in the treatment of RA,which helps determine drug options for RA patients with latent tuberculosis infection (LTBI) and RA patients in geographical regions with a high prevalence of tuberculosis.

Research progress on the drug resistance and mechanism of the anti-tuberculosis drug bedaquiline

Yao Rong, Lu Yu

Chinese Journal of Antituberculosis. 2022, 44(9):  973-977.  doi:10.19982/j.issn.1000-6621.20220122

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With the increase of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) strains, drug resistance of Mycobacterium tuberculosis (MTB) has become an urgent problem worldwide. Bedaquiline (Bdq) is the first new drug specifically in the treatment of MDR-TB in recent 50 years, and its drug resistance been gradually concerned. The research progress of drug resistance characteristics and drug resistance gene mutations of Bdq were reviewed, in order to better guide clinical medication, improve the success rate of treatment, and reduce the occurrence of drug resistance.

Research progress of sputum specimen collection in patients with pulmonary tuberculosis

Xie Fanghui, Liang Li, Zhao Xia, Yao Rong, Lei Limei, Guo Hui, Meng Meng, Wan Bin

Chinese Journal of Antituberculosis. 2022, 44(9):  978-982.  doi:10.19982/j.issn.1000-6621.20220188

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The diagnosis of pulmonary tuberculosis is based on the results of etiology (including bacteriology and molecular biology), and the sensitivity of etiology is affected by the quality of sputum samples. The quality of sputum samples is related to the collection time and method. This paper reviews the collection time, collection methods and intervention measures of sputum samples from patients with pulmonary tuberculosis, so as to provide reference for improving the etiological detection rate.