Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis in Multi-Ethnic Region, Xinjiang Uygur Autonomous Region, China

Abstract

BackgroundThe multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) has emerged as a global threat. Xinjiang is a multi-ethnic region and suffered second highest incidence of TB in China. However, epidemiological information on MDR and XDR TB is scarcely investigated.Methodology/Principal FindingsA prospective study was conducted to analyze the prevalence of MDR and XDR TB and the differences of drug resistance TB between Chinese Han and other nationalities population at Chest Hospital of Xinjiang Uygur Autonomous Region, China. We performed in vitro drug susceptibility testing of Mycobacterium tuberculosis to first- and second-line anti-tuberculosis drugs for all 1893 culture confirmed positive TB cases that were diagnosed between June 2009 and June 2011. Totally 1117 (59.0%, 95% CI, 56.8%–61.2%) clinical isolates were resistant to ≥1 first-line drugs; the prevalence of MDR TB was 13.2% (95% CI, 11.7%–14.7%), of which, 77 (30.8%; 95% CI, 25.0%–36.6%) and 31 (12.8%; 95% CI, 8.6%–17.0%) isolates were pre-XDR and XDR TB respectively. Among the MDR/XDR TB, Chinese Han patients were significantly less likely to be younger with an odds ratio 0.42 for age 20–29 years and 0.52 for age 40–49 years; P trend = 0.004), and Chinese Han patients has a lower prevalence of XDR TB (9.6%) than all the other nationality (14.9%).Conclusions/SignificanceThe burden of drug resistance TB cases is sizeable, which highlights an urgent need to reinforce the control, detection and treatment strategies for drug resistance TB. However, the difference of MDR and XDR TB between Chinese Han and other nationalities was not observed.

Risk Factors for Poor Treatment Outcomes in Patients With MDR-TB and XDR-TB in China: Retrospective Multicenter Investigation

“…The percentage of XDR-TB was higher than in the previous surveillance data in China [16][17][18][19], in Taiwan [20], and in other countries [9,21,22], and it was similar to the 23.9% which was reported from South Africa in TB and HIV co-infected patients [23][24][25], similar to the 23.59% from nationwide population-based survey in China [5] and to 20.0% found in the study from Shandong [6]. The high prevalence of XDR-TB could be explained by the fact that our study subjects were from provincial Tuberculosis Specialized Hospitals, where the patients might tend to be selected as being relatively difficult cases.…”

Molecular Characterization of Multidrug-Resistant Mycobacterium tuberculosis Isolates from China

“…The reported percentage of XDR-TB strains among MDR-TB strains varies between provinces in China, ranging from 6.3% to 18.7% (13,15,16,(22)(23)(24). Our results showed that the proportion of XDR-TB isolates in this study was 10.2% (13/128 isolates).…”

High prevalence and low cure rate of tuberculosis among patients with HIV in Xinjiang, China

“…The information on the prevalence of multidrug-resistant (MDR) and extensively drug-resistant (XDR TB) remains scant in the region, due to TB drug susceptibility testing (DST) not being implemented as a routine test at most hospitals. It was performed in combination with a clinical study in Urumqi from 2009 to 2011, and indicated a prevalence of MDR TB of 13.2% [13]. …”