Prevalence of Multidrug-Resistant Tuberculosis in Dalian, China: A Retrospective Study

Du, Liang; Zhang, Yu; Lv, Xuemei; Duan, Yuxin; Shi, Xiaoyan; Ji, Haoqiang; Wu, Ruiheng; Xu, Jia; Chen, Xu; Gao, Yang; Lu, Xiwei; Zhou, Ling

doi:10.2147/idr.s294611

Cited by 8 publications

(10 citation statements)

References 36 publications

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“…Dalian, which is located in northeast China, has a residential population of 6.95 million, and suffers from a high TB burden. 27 The incidence of TB was 52.8 per 100,000, and new MDR/RR-TB cases accounted for 4.8% in the region, higher than the global level. 27 In Dalian, information from all TB patients is collected regularly with TB surveillance and management through the China Information System for TB Prevention and Control.…”

Section: Study Populationmentioning

confidence: 90%

“…27 The incidence of TB was 52.8 per 100,000, and new MDR/RR-TB cases accounted for 4.8% in the region, higher than the global level. 27 In Dalian, information from all TB patients is collected regularly with TB surveillance and management through the China Information System for TB Prevention and Control. TB cases in the study were diagnosed by sputum smear examination, sputum culture or the WHO clinical criteria from Jan 1, 2014, to Dec 31, 2019.…”

Section: Study Populationmentioning

confidence: 90%

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Cut-off Points of Treatment Delay to Predict Poor Outcomes Among New Pulmonary Tuberculosis Cases in Dalian, China: A Cohort Study

Ji¹,

Xu²,

Wu³

et al. 2021

IDR

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Purpose: Despite increasing literature on the association between treatment delay and outcomes, cut-off point (1 month or median) selection in almost all studies for treatment delay is too subjective. This study explored more scientific cut-off points of treatment delay for poor treatment outcomes and death at the clinical level. Patients and Methods: A total of 18,100 newly confirmed pulmonary tuberculosis (TB) cases in Dalian, China were used in the final analysis. A 3-knotted restricted cubic spline (RCS) fitted for Cox proportional hazard regression models is used to analyse the effects of cut-off points of treatment delay on incident poor treatment outcomes. To explore the moderating effects of age, gender and diabetes, we added the interaction terms of these moderating variables and treatment delay to Cox proportional hazard regression models. Results:The median time of treatment initiation was 30 days (IQR: 14-59 days). The risk of incident poor treatment outcomes increased when the time was greater than cut-off point 1 (53 days; adjusted HR: 1.26; 95% CI: 1.00-1.60) of treatment delay, and the risk of incident death events increased when the time was greater than cut-off point 2 (103 days; adjusted HR: 1.56; 95% CI: 1.00-2.44) of delay. In addition, treatment delay was associated with an increased risk of incident poor treatment outcomes and death, and older age, male sex, and diabetes may increase the risk of treatment delay for poor outcomes. Conclusion:This study is the first to identify scientific cut-off points of treatment delay for poor treatment outcomes and death, and this method of exploration should be popularized. In addition, the knowledge of tuberculosis must be spread to every adult. Moreover, the tuberculosis diagnosis level of community level health workers should be enhanced.

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Section: Study Populationmentioning

confidence: 90%

Section: Study Populationmentioning

confidence: 90%

Cut-off Points of Treatment Delay to Predict Poor Outcomes Among New Pulmonary Tuberculosis Cases in Dalian, China: A Cohort Study

Ji¹,

Xu²,

Wu³

et al. 2021

IDR

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“…There is a high prevalence of TB in Dalian. 15 The incidence of TB in the region is 52/100,000, which is well above the global average. 16 However, the Directly Observed Treatment and Short Course (DOTS) strategy and the Global Fund for MDR-TB Prevention and Treatment project have been implemented in this region since 2012.…”

Section: Introductionmentioning

confidence: 93%

“… 16 However, the Directly Observed Treatment and Short Course (DOTS) strategy and the Global Fund for MDR-TB Prevention and Treatment project have been implemented in this region since 2012. 15 Many patients with suspected DR-TB are diagnosed in Dalian every year, and these patients can easily develop MDR-TB or even XDR-TB.…”

Section: Introductionmentioning

confidence: 99%

Drug Resistance Patterns and Trends in Patients with Suspected Drug-Resistant Tuberculosis in Dalian, China: A Retrospective Study

Pan¹,

Yu²,

Lu³

et al. 2022

IDR

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Purpose The emergence of drug-resistant tuberculosis (DR-TB) represents a threat to the control of tuberculosis. This study aimed to estimate the patterns and trends of DR-TB in patients with suspected DR-TB. In addition, risk factors for multidrug-resistant tuberculosis (MDR-TB) were identified among suspected DR-TB patients in Dalian, China. Patients and Methods A total of 5661 patients with suspected DR-TB from Jan 1, 2013 to Dec 31, 2020 were included in the final analysis. The resistance pattern of all resistant strains was determined by drug susceptibility testing (DST) using the conventional Lowenstein-Jensen Proportion Method (LJ). DR-TB trends were estimated from 2013 to 2020. During the research period, the chi-square test was employed to analyze the significance of linear drug-resistance trends across time. Bivariate and multivariate logistic regression were performed to assess factors associated with MDR-TB. Results From 2013 to 2020, the resistance rates of rifampicin (RFP) and isoniazid (INH) decreased significantly, whereas the resistance rates of ethambutol (EMB) and streptomycin (SM) increased in patients with suspected DR-TB. From 2013 to 2020, the prevalence of DR-TB decreased in all patients from 34.71% to 28.01% with an average annual decrease of 3.02%. Among new cases, from 2013 to 2020, the prevalence of DR-TB (from 26.67% to 24.75%), RFP-resistant TB (RR-TB) (from 15.09% to 3.00%) and MDR-TB (from 6.08% to 2.62%) showed a significant downward trend. Among patients with a previous treatment history, DR-TB (from 54.70% to 37.50%), RR-TB (from 44.16% to 11.49%) and MDR-TB (from 26.90% to 10.34%) showed a significant downward trend from 2013 to 2020. Males (AOR 1.28, 95% CI 1.035–1.585), patients 45 to 64 years of age (AOR 1.75, 95% CI 1.342–2.284), patients 65 years and older (AOR 1.65, 95% CI 1.293–2.104), rural residents (AOR 1.24, 95% CI 1.014–1.519) and a previous treatment history (AOR 3.94, 95% CI 3.275–4.741) were risk factors for MDR-TB. Conclusion The prevalence of DR-TB, RR-TB and MDR-TB was significantly reduced from 2013 to 2020. Considerable progress has been made in the prevention and treatment of DR-TB during this period. However, the increasing rate of drug resistance in EMB and SM should be taken seriously. Suspected DR-TB patients who are male, older than 45 years of age, live in rural areas, and have a history of TB treatment should be given priority by health care providers.

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“…Identifying the drug-resistant rate of tuberculosis is essential, especially in areas with high tuberculosis rates, including the Southeast and the Mekong Delta 3 . Recently, many studies have been published that found rates of TB resistance in Ha Noi, Vietnam (2019) 4 , India (2020) 5 , Dalian, China (2021) 6 . However, few studies have been conducted to establish the proportion of drug resistance in Can Tho City (Mekong Delta).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of drug-resistant recurrent tuberculosis and new multidrug-resistant tuberculosis mutations detection in Can Tho, Vietnam

Duong¹,

Tan²,

Tran³

et al. 2022

Pharm Sci Asia

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Tuberculosis (TB) has been a threat to world health for decades. Multidrug-resistant TB (MDR-TB) is adding to the burden of disease and hindering the development of countries. This study aimed to identify the drug-resistant rate in patients with recurrent pulmonary TB and detect rifampicin resistance mutations in the rpoB gene in Can Tho, Vietnam. In this descriptive cross-sectional study, clinicians diagnosed the patients with recurrent pulmonary TB and were hospitalized. Smear-positive sputum specimens (n=246) were collected to determine the rate of drug resistance. To identify mutations in the rpoB gene which are likely to be associated with rifampicin resistance in MDR-TB, we sequenced 40 isolates of Mycobacterium tuberculosis collected between 2012 and 2014; mainly MDR-TB (n=40; 95.2%) and rifampicin-sensitive TB (n=2; 4.8%). The rate of drug-resistant pulmonary tuberculosis was 63.8%, and the rate of MDR-TB accounted for 23.2%. The mutations in rpoB were predominantly in codons 531 (27.5%) and 523 (17.5%), with rare occurrences of S522A (2.5%) and A532P (2.5%). Noticeably, there was a substitution mutation in codon 532, and a mutant strain of tuberculosis at seven codons in the rpoB gene had been detected. In conclusion, this study provided drug-resistant characteristics in patients with recurrent pulmonary TB and mutations of MDR-TB in Can Tho, Vietnam. The results show a mutation in codon 532 of the rpoB gene and a mutant strain of tuberculosis at all seven codons. These are remarkable and promising results for further studies and clinical applications.

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Prevalence of Multidrug-Resistant Tuberculosis in Dalian, China: A Retrospective Study

Cited by 8 publications

References 36 publications

Cut-off Points of Treatment Delay to Predict Poor Outcomes Among New Pulmonary Tuberculosis Cases in Dalian, China: A Cohort Study

Cut-off Points of Treatment Delay to Predict Poor Outcomes Among New Pulmonary Tuberculosis Cases in Dalian, China: A Cohort Study

Drug Resistance Patterns and Trends in Patients with Suspected Drug-Resistant Tuberculosis in Dalian, China: A Retrospective Study

Prevalence of drug-resistant recurrent tuberculosis and new multidrug-resistant tuberculosis mutations detection in Can Tho, Vietnam

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