Predictors and Trends of MDR/RR-TB in Shenzhen China: A Retrospective 2012–2020 Period Analysis

Abstract

We analyzed the trends and predictors of multidrug-resistant (MDR) or rifampicin-resistant (RR) tuberculosis (TB) in culture-positive cases in Shenzhen during 2012-2020, after the implementation of improved strategies (scale-up molecular drug susceptibility testing [mDST], expansion of DST eligibility, and generous reimbursement of MDR-TB outpatient care costs). Materials and Methods:We retrospectively extracted and analyzed data from the TB Information System on drug-resistant pulmonary tuberculosis diagnosed in Shenzhen during the 2012-2020 period. We analyzed trends in RR-and MDR-TB rates in new cases during 2012-2018 and 2018-2020 periods, and among previously-treated cases during 2012-2017 and 2017-2020 periods, using Cochran-Armitage tests. We generated multivariate logistic regression models to analyze demographic predictors of MDR/RR-TB rates. Results: We found 21,367 positive mycobacterial cultures in Shenzhen during the 2012-2020 period, and 19,951 (93.4%) were identified as Mycobacterium tuberculosis and had DST results (92.0% of those were mDST-based). Of these patients with DST results, 1630 (8.2%) were RR-TB, and 1142 (5.7%) were MDR-TB. Of the RR-TB, 70% were MDR-TB. The MDR/RR-TB rate in new TB cases increased significantly during the 2012-2018 period (P trend < 0.05), but it decreased in the 2018-2020 period (P trend > 0.05, with a significant trend for MDR-TB). Among previously treated cases, the temporal MDR/RR-TB rate trends did not differ significantly (P trend > 0.05). Our multivariate analysis showed that age younger than 30 years, housework service/unemployment, local residency, and previous TB treatment were all predictors of MDR/RR-TB. The percentage of patients with MDR-TB on treatment increased from 49.4% in 2012 to 70.5% in 2020. The treatment success rate of patients with MDR-TB during the 2012-2018 period was 71%. Conclusion:During the study period in Shenzhen, the cases of MDR/RR-TB were detected, and the treatment enrollment increased and the MDR-TB rates decreased gradually after 2017. Decreasing trends may reflect the efficacy of improved strategies; however, their longterm impact on the MDR-TB burden remains to be investigated. The predictors of MDR-TB identified in our study should be considered when developing targeted MDR-TB control strategies.

Multidrug-Resistant Tuberculosis Treatment Outcome and Associated Factors at the University of Gondar Comprehensive Specialized Hospital: A Ten-Year Retrospective Study

“…14 According to the reports, up to 90% of RR-TB cases are resistant to isoniazid. 15 As a result, in countries with limited MDR-TB laboratory diagnostic capacity, RR-TB is utilized as a surrogate marker for MDR-TB. 16 Globally, 3–4% of new and 18–21% of previously treated cases are diagnosed with MDR/RR-TB.…”

Analysis of drug resistance in pulmonary tuberculosis patients with positive sputum tuberculosis culture in Northeast China

“…This study confirms that treatment history, including initial and recurrent treatment, is the only factor associated with multidrug resistance when using univariate logistic regression analysis. Recurrent patients are Chakaya et al, 2021;Lecai et al, 2021). The development of initially treated drug-resistant tuberculosis into retreatment drug-resistant tuberculosis can be influenced by various factors, including long treatment cycles, improper use of antituberculosis drugs, drug side effects, poor patient compliance, economic difficulties, and other reasons.…”

Thực Trạng Phát Hiện Và Một Số Yếu Tố Liên Quan Đến Lao Kháng Rifampicin Tại Thái Nguyên Giai Đoạn 2014 - 2022

“…Đối với thể lao lâm sàng thì ở những trường hợp lao cũ có nguy cơ mắc lao kháng Rifampicin cao gấp 11,96 lần (95%CI: 8,59 -16,78) so với trường hợp lao mới. Theo nghiên cứu của Lecai J và cộng sự thì cũng đã thấy được ở những bệnh nhân đã điều trị lao trước đây có nguy cơ cao mắc lao kháng Rifampicin [5].…”