Drug resistance profiles and trends in drug-resistant tuberculosis at a major hospital in Guizhou Province of China

Abstract

Objectives: Tuberculosis (TB) is the leading cause of death from infectious diseases in the world, with an estimated 1.6 million deaths from TB in 2017. The objectives of this study were to determine drug resistance profiles of Mycobacterium tuberculosis clinical isolates and to analyze the trends in drug-resistant and multidrug-resistant tuberculosis (MDR-TB) from 2008 to 2015 at a major hospital in Guizhou, a high-TB burden and resource-limited province of China. Patients and methods: A total of 462 clinical isolates were collected from patients with pulmonary TB during the period from January 2013 to December 2015 and used for determining drug resistance profiles against four first-line and six second-line anti-TB drugs, and the results were compared with those of two previous studies. Results: Exactly 4.4% of new and 44.1% of previously treated TB cases were MDR/rifampicinresistant TB (RR-TB), which were higher than the 2017 global average numbers of 3.5% and 18%, respectively. There were many drug-resistant patterns among MDR-TB isolates and most of them were resistant to three or four anti-TB drugs. The trends in drug-resistant and MDR-TB declined at the hospital from 2008 to 2015. Conclusion: Results of this study show that the prevalence of MDR/RR-TB at a major hospital in Guizhou is higher than the global average and confirm the existence of heterogeneity in drug resistance patterns of MDR-TB isolates. Additionally, three practical measures have played an important role in the overall decline of MDR-TB at the hospital from 2008 to 2015.

<p>Resistance To First-Line Antituberculosis Drugs And Prevalence Of <em>pncA</em> Mutations In Clinical Isolates Of <em>Mycobacterium tuberculosis</em> From Zunyi, Guizhou Province Of China</p>

“…During the current study, M. tuberculosis clinical isolates were collected from 318 TB patients and the proportion of male to female patients was 61.6% to 38.4%, which was consistent with our previous study for male (62.8%) and female (37.2%) patients 15. However, the proportion of previously treated cases in this study (41.2%) was higher than that in our previous study (31%),15 probably because only in-patients were enrolled in this study.…”

“…During the current study, M. tuberculosis clinical isolates were collected from 318 TB patients and the proportion of male to female patients was 61.6% to 38.4%, which was consistent with our previous study for male (62.8%) and female (37.2%) patients 15. However, the proportion of previously treated cases in this study (41.2%) was higher than that in our previous study (31%),15 probably because only in-patients were enrolled in this study. For the same reason, rates of MDR-TB in new (18.7%, 35/187) and previously treated TB cases (69.7%, 89/131) were higher than those in our previous studies15 and combined data from 53 Member States in the WHO European Region (15.7% of new and 45.3% of previously treated cases of TB were MDR-TB) 16.…”

<p>Prevalence, risk and genetic characteristics of drug-resistant tuberculosis in a tertiary care tuberculosis hospital in China</p>

“…The proportions of MDR- and XDR-TB in this study were 9.5% and 1.1%, similar to the data from Shandong,20 but lower than data from Beijing,19 Guizhou,18 Jiangxi,17 Hunan,9 Shanghai21 and Xinjiang 16. These findings confirmed that there is a wide variation in drug resistance among regions in China.…”

The burden of pre-extensively and extensively drug-resistant tuberculosis among MDR-TB patients in the Amhara region, Ethiopia

“…Among 10 pre-XDR-TB isolates, 90% were previously treated with first line drug for active TB disease although not statistically significant (p = 0.07). This variation in drug resistance patterns of MDR-TB isolates is due to mutational heterogeneity in mycobacterial genes associated with anti-TB drug resistance [36], and also could be due to transmission from person-to-person and de novo evolution of resistance. WHO suggested that treatment decisions should be guided based on the patient's clinical history and recent surveillance data in settings with lack of SLDs DST [37].…”