Abstract:

Objective To analyze the drug resistance and distribution of smear positive pulmonary tuberculosis patients in Anhui province.Methods Using stratified cluster sampling method, 42 sampling survey points in Anhui province were extracted. A total of 3047 patients with smear-positive pulmonary tuberculosis was collected from September 15, 2015 to August 31, 2016, and were cultured by Roche solid (101 were polluted (3.31%), 275 were negative (9.03%), 2671 were positive (87.66%)) and anti-drug sensitivity test of 6 anti-TB drugs (including isoniazid (INH), rifampin (RFP), ethambutol (EMB), streptomycin (Sm), ofloxacin (Ofx) and kanamycin (Km)). Finally 141 cases were identified as non-tuberculosis mycobacteria (NTM), and results of drug sensitivity test were acquired from 2530 cases. SPSS 19.0 was used for statistical analysis, and the counting data were analyzed by the χ ² test. P<0.05 was considered statistically significant. Results A total of 1861 strains (73.56%) were all sensitive of INH, RFP, EMB, Sm, Ofx, Km in 2530 strains of Mycobacterium tuberculosis isolates, 669 strains (26.44%) were resistant to one or more anti-TB drugs. All of them (2530 strains), clinical isolates from initial (84.31%, 2133/2530) and re-treat patients (15.69%, 397/2530) had the highest percentages in INH (13.32%, 337/2530), Sm (10.97%, 234/2133), RFP (31.74%, 126/397), respectively. The resistant rates of INH (10.45%, 223/2133), RFP (7.64%, 163/2133), Sm (10.97%, 234/2133), EMB (1.88%, 40/2133) and Ofx (6.52%, 139/2133) in initial patients were significantly lower than those in re-treat patients (28.72% (114/397), 31.74% (126/397), 21.91% (87/397), 8.56% (34/397) and 21.66% (86/397); χ ²=96.66, 192.07, 36.19, 52.74, 94.76, respectively, all P=0.000). The multidrug resistance rates were 7.63% (193/2530), 4.97% (106/2133) and 21.91% (87/397) for all, initial and re-treat patients, respectively. The poly-resistance rates were 12.41% (314/2530), 8.95% (191/2133) and 30.98% (123/397), respectively. The extensively drug-resistant rates were 0.91% (23/2530), 0.61% (13/2133) and 2.52% (10/397), respectively. Conclusion The drug resistance rate of patients with smear positive pulmonary tuberculosis in Anhui province is relatively high for any drug resistance, and the drug resistance rate of INH is the highest. The resistance rate of Sm was the highest in the initial treatment patients, and RFP is the highest in the retreatment patients. The epidemic of drug-resistant tuberculosis in Anhui province cannot be ignored.

Key words: Tuberculosis, pulmonary, Tuberculosis, multidrug-resistant, Sampling studies, Data interpretation, statistical, Small-area analysis