Abstract:

The drug susceptibility testing (DST) results and relevant information were collected from 499 patients who were diagnosed as sputum culture-positive pulmonary tuberculosis (TB), identified as Mycobacterium tuberculosis (MTB) infection and combined with diabetes mellitus (DM), were hospitalized at Shenyang Chest Hospital for treatment from July 2016 to June 2017. The DST results and the related information were retrospective analyzed. Among those enrolled patients, 235 patients were initial treatment cases (initial treatment group) while 264 patients were retreatment cases (re-treatment group). The DST was performed by absolute concentration method for 11 anti-TB drugs. The results showed that the overall drug resistant rate was 50.70% (253/499); the overall drug resistant rate in the initial treatment group (29.79%, 70/235) was statistically significant lower than that in the re-treatment group (69.32%, 183/264) (χ ²=79.32, P<0.01). The mono-drug-resistant rate in 499 MTB strains was 14.83% (74/499); this rate in the initial treatment group and the re-treatment group was 14.04% (33/235) and 15.53% (41/264) respectively, there was no statistically significant difference between the two groups (χ ²=0.22, P=0.641). The poly-drug-resistant rate in 499 MTB strains was 12.63% (63/499); this rate in the initial treatment group (2.98%, 7/235) was statistically significant lower than that in the re-treatment group (21.21%, 56/264) (χ ²=37.47, P<0.01). The multidrug-resistant (MDR) rate in 499 MTB strains was 23.25% (116/499); the MDR rate in the initial treatment group and the re-treatment group was 12.77% (30/235) and 32.58% (86/264) respectively, the former was statistically significant lower than the latter (χ ²=27.35, P<0.01). The extensively drug-resistant (XDR) rate in 499 MTB strains was 3.01% (15/499); the XDR rate in the initial treatment group and the re-treatment group was 0.85% (2/235) and 4.92% (13/264) respectively, and the former was statistically significant lower than the latter (χ ²=7.08, P=0.008). The drug resistant rate of rifampicin was 29.26% (146/499); this rate was 15.74% (37/235) in the initial treatment group, and was statistically significant lower than that in the re-treatment group (41.29%, 109/264) (χ ²=39.19, P<0.01). According to the DST results, the reasonable and effective treatment regimens for drug resistant TB can be established, which can also provide reference for the formulation of clinical chemotherapy regimens and the development of drug-resistant TB prevention and control strategy.

Key words: Tuberculosis, pulmonary, Diabetes mellitus, Comorbidity, Tuberculosis, multidrug-resis-tant, Data interpretation, statistical