Abstract:

Objective Understand and analyze the drug resistance characteristics of MDR/XDR-TB patients complicated with type 2 diabetes mellitus. Methods Collect 233 MDR/XDR-TB patients diagnosed by Mycobacterium tuberculosis culture and drug sensitivity test (referred to as “drug sensitivity test”) from the drug-resistant ward of Infectious Hospital of Heilongjiang Province from June 2018 to June 2020, among them, 84 cases were complicated with type 2 diabetes mellitus (referred to as “concurrent DM group”) and 149 cases were not complicated with DM (referred to as “non-concurrent DM group”). The initial retreatment, drug resistance and drug resistance spectrum of the two groups were analyzed, SPSS 18.0 software was used for statistical analysis, the count data was expressed as percentage, the constituent ratio or rate between groups was compared by Chi square test,P<0.05 as the statistically significant difference. Results There were 26 cases of initial treating pulmonary tuberculosis in the concurrent DM group, accounting for 30.95% (26/84), and 16 cases in the non-concurrent DM group, accounting for 10.74% (16/149), the difference between the two groups was statistically significant (χ ²=14.854, P<0.01). In terms of the number of drugs resistance, the concurrent DM group was compared with the non-concurrent DM group, the rates of resistance to isoniazid and rifampin were 10.71% (9/84), 7.39% (11/149), the rates of resistance to 3 drugs, respectively were 28.57% (24/84) and 24.16% (36/149), the rates of resistance to 4 drugs were 19.05% (16/84) and 24.83% (37/149), the rates of resistance to 5 drugs were 17.86% (15/84) and 19.46% (29/149), and the rates of resistance to 6 or more drugs were 23.81% (20/84) and 24.16% (36/149) respectively, there was no statistical significance difference between the two groups (χ ² values were 0.759, 0.546, 1.023, 2.063 and 0.882, and the P values were 0.383, 0.460, 0.312, 0.151 and 0.348). In terms of drug resistance spectrum, the concurrent DM group was compared with the non-concurrent DM group, the resistance rates of isoniazid and rifampin were 10.71% (9/84) and 7.40% (11/149), the rates of fluoroquinolone resistance were 29.76% (25/84) and 29.53% (44/149), the rate of resistance to injection of second-line anti-tuberculosis drugs were 4.76% (4/84) and 6.71% (10/149), the rates of simultaneous resistance to isoniazid and rifampicin, fluoroquinolones, and second-line anti-tuberculosis drugs simultaneously were 8.33% (7/84) and 13.42% (20/149) respectively, there was no statistical significance difference between the two groups (χ ² were 0.760, 0.009, 0.361 and 1.358, and the P values were 0.383, 0.926, 0.548 and 0.244). Conclusion The majority of MDR/XDR-TB patients complicated with type 2 diabetes mellitus were initial treating pulmonary tuberculosis. Whether complicated with diabetes mellitus had no effect on the number of resistant drugs and the drug resistance spectrum of MDR/XDR-TB patients. It is suggested that we should strengthen the protection of susceptible population such as diabetes, to avoid the occurrence of primary drug-resistant tuberculosis due to infection of drug-resistant Mycobacterium tuberculosis.

Key words: Tuberculosis,pulmonary, Tuberculosis,multidrug-resistant, Diabetes mellitus,type 2, Comorbidity, Drug resistance characteristics, Data interpretation,statistical