Analysis of drug resistance of 1156 clinical isolates of Mycobacterium tuberculosis

doi:10.3969/j.issn.1000-6621.2021.07.007

Abstract

Abstract: Objective Analyze the drug resistance of clinical isolates of Mycobacterium tuberculosis(MTB) in pulmonary tuberculosis patients managed by the Beijing tuberculosis prevention and control institutions to support the prevention and treatment of tuberculosis in Beijing. Methods The 1241 positive isolates of mycobacteria from January to December in 2019 all came from the Beijing tuberculosis prevention and control institutions. Identification (PNB/TCH growth test) and drug susceptibility tests of M.tuberculosis (the proportion method for 8 anti-tuberculosis drugs) were carried out. Drugs for sensitivity tests included INH,RFP,Sm,EMB,Lfx,Am,Cm and PAS. Results Among the 1241 mycobacteria positive isolates in 2019,1156 (93.15%) strains were MTB, and 85 (6.85%) strains were non-tuberculous mycobacteria (NTM). Among the 1156 MTB isolates, the total drug resistant rate was 24.83% (287/1156). The drug-resistant rate was 7.27% (84/1156), 6.75% (78/1156),5.28% (61/1156),1.73% (20/1156) and 0.17% (2/1156) for RFP, PDR, MDR, Pre-XDR and XDR respectively. The order of resistance to 8 anti-tuberculosis drugs was Sm (17.91%,207/1156) > INH (11.76%,136/1156) > RFP (7.27%,84/1156) > EMB (4.84%,56/1156) > Lfx (4.76%,55/1156) > PAS (2.16%,25/1156) > Cm (1.47%,17/1156) > Am (0.69%,8/1156). There were 43 types of drug-resistant profiles, including 7 monoresistant, 6 MDR,8 Pre-XDR,1 XDR, 21 PDR. Conclusion The drug resistance profiles of clinical isolates of tuberculosis patients managed by the Beijing tuberculosis prevention and control institutions are diverse and complex. We should strengthen the screening of drug-resistant tuberculosis patients for the management and treatment of drug-resistant tuberculosis patients preferably.

Key words: Mycobacterium tuberculosis, Bacteriological techniques, Microbial sensitivity tests, Drug resistance, bacterial, Epidemiologic studies

YI Jun-li, YANG Xin-yu, CHEN Hao, ZHAO Yan-feng, CHEN Shuang-shuang, ZHANG Jie, DING Bei-chuan, DAI Xiao-wei, SUN Shan-hua, WU Wen-qing, LI Chuan-you. Analysis of drug resistance of 1156 clinical isolates of Mycobacterium tuberculosis[J]. Chinese Journal of Antituberculosis, 2021, 43(7): 677-681. doi: 10.3969/j.issn.1000-6621.2021.07.007

Figures/Tables 4

References 13

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来源特征	总菌株数 (株)	耐药				耐多药				利福平耐药
来源特征	总菌株数 (株)	菌株数 (株)	耐药率 (%)	χ²值	P值	菌株数 (株)	耐药率 (%)	χ²值	P值	菌株数 (株)	耐药率 (%)	χ²值	P值
性别				1.292	0.256			1.530	0.216			0.156	0.693
男	820	196	23.90			39	4.76			58	7.07
女	336	91	27.08			22	6.55			26	7.74
年龄(岁)				6.744	0.081			5.703	0.127			7.293	0.063
0~19	46	9	19.57			4	8.70			4	8.70
20~39	527	135	25.62			31	5.88			46	8.73
40~59	291	84	28.87			18	6.19			23	7.90
≥60	292	59	20.21			8	2.74			11	3.77
户籍				0.028	0.866			1.181	0.277			2.882	0.090
本市	571	143	25.04			26	4.55			34	5.95
外地	585	144	24.62			35	5.98			50	8.55
治疗情况				16.508	0.000			-^a	0.000			-^a	0.000
初治	1102	261	23.68			50	4.54			71	6.44
复治	54	26	48.15			11	20.37			13	24.07

药物名称	菌株(1156株)		初治(1102株)		复治(54株)		χ²值	P值
药物名称	菌株数(株)	耐药率(%)	菌株数(株)	耐药率(%)	菌株数(株)	耐药率(%)	χ²值	P值
INH	136	11.76	118	10.71	18	33.33	25.386	0.000
RFP	84	7.27	71	6.44	13	24.07	-^a	0.000
Sm	207	17.91	188	17.06	19	35.19	11.504	0.001
EMB	56	4.84	47	4.26	9	16.67	-^a	0.001
Lfx	55	4.76	49	4.45	6	11.11	-^a	0.039
Am	8	0.69	6	0.54	2	3.70	-^a	0.050
Cm	17	1.47	16	1.45	1	1.85	-^a	0.559
PAS	25	2.16	24	2.18	1	1.85	-^a	1.000

耐药谱	菌株数 (株)	耐药率 (%)
单一耐药	147	51.22
INH	22	7.67
RFP	11	3.83
Sm	81	28.22
EMB	2	0.70
Lfx	28	9.76
Cm	1	0.35
PAS	2	0.70
MDR(不含Pre-XDR、XDR)	39	13.59
INH+RFP	5	1.74
INH+RFP+Sm	11	3.83
INH+RFP+EMB	1	0.35
INH+RFP+Sm+EMB	16	5.57
INH+RFP+Sm+PAS	1	0.35
INH+RFP+Sm+EMB+PAS	5	1.74
Pre-XDR	20	6.97
INH+RFP+Sm+Lfx	1	0.35
INH+RFP+Sm+Am	1	0.35
INH+RFP+Sm+EMB+Lfx	12	4.18
INH+RFP+Sm+EMB+Lfx+PAS	1	0.35
INH+RFP+Sm+EMB+Am+Cm	1	0.35
INH+RFP+Sm+EMB+Am+Cm+PAS	2	0.70
INH+RFP+Sm+EMB+Cm	1	0.35
INH+RFP+Sm+EMB+Cm+PAS	1	0.35
XDR	2	0.70
INH+RFP+Sm+EMB+Lfx+Am+Cm	2	0.70
PDR	79	27.53
仅含一线抗结核药	44	15.33
INH+Sm	37	12.89
RFP+Sm	6	2.09
RFP+EMB	1	0.35
含二线抗结核药	35	12.20
INH+Sm+Lfx	1	0.35
INH+Sm+Lfx+PAS	1	0.35
INH+Sm+Cm	3	1.05
INH+Sm+PAS	6	2.09
INH+EMB+PAS	1	0.35
INH+Sm+EMB+PAS	1	0.35
INH+Lfx	1	0.35
INH+PAS	2	0.70
RFP+Sm+EMB	2	0.70

耐药谱	菌株数 (株)	耐药率 (%)
RFP+EMB+Lfx	2	0.70
RFP+Sm+EMB+Am+Cm	1	0.35
Sm+EMB	3	1.05
Sm+EMB+Cm	1	0.35
Sm+Lfx	5	1.74
Sm+Cm	2	0.70
Sm+PAS	1	0.35
Sm+Am+Cm+PAS	1	0.35
Lfx+Cm	1	0.35

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