Prevalence of tuberculosis drug resistance in 10 provinces of China

He, Guo; Zhao, Yan; Jiang, Guang Lu; Liu, Yu Hong; Xing, Hui; Wang, Sheng Fen; Wang, Li Xia; Borgdorff, Martien W.; Werf, Marieke J. van der; Hof, Susan van den

doi:10.1186/1471-2334-8-166

Cited by 58 publications

(54 citation statements)

References 3 publications

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“…He et al reported the prevalence of any drug resistance in 10 provinces of China as 24.3% (range 14.8% -42.1%) among new cases and 51.8% (range 27.5% -67.5%) among previously treated cases. In contrast, the prevalence of MDR-TB was 5.4% (range 2.1% -10.4%) among new cases and 25.6% (range 11.7%-36.9%) among previously treated cases [19]. In comparison to our study, lower MDR-TB rates, specifically 2% for new cases and 29.4% for previously treated cases, were reported from the WHO Eastern Mediterranean Region [20].…”

Section: Discussioncontrasting

confidence: 94%

Anti-tuberculosis drug resistance and associated risk factors in a tertiary level TB center in Iran: a retrospective analysis

Merza

Farnia

Tabarsi

et al. 2011

J Infect Dev Ctries

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Introduction: This study aimed to determine first-line anti-tuberculosis drug resistance rates in new and previously treated cases and to identify risk factors associated with multidrug resistant tuberculosis (MDR-TB) at the National Reference Tuberculosis Laboratory of Iran. Methodology: This was a retrospective analysis of all confirmed TB patients from December 2000 to June 2005. Drug susceptibility testing to isoniazid, rifampicin, streptomycin, ethambutol and pyrazinamide was performed on Löwenstein-Jensen (LJ) medium according to the proportion method. Results: Mycobacterium tuberculosis strains were isolated from 1,742 patients with TB, of whom 935 (53.7%) were male. The mean age of patients was 44.2 ± 17.4 years (SD). A total of 1,074 patients were native Iranians while 668 (38.3%) were immigrant patients. Out of 1,139 (65.4%) new cases, 340 (29.9%) had at least one drug resistance. Of 603 (34.6%) previously treated cases, 416 (69.0%) had resistant strains. There were 263 patients (15.1%) with MDR-TB, 72 of whom were new (6.3% of all new cases) and 191 were previously treated (31.7% of all previously treated cases). Factors associated with MDR-TB included age under 45 years, male sex, previous TB treatment, immigration, poor living conditions, and unemployment. Conclusions: The high rate of initial resistance in MDR-TB cases and the high rate of MDR-TB in a young age group were indicators of recent transmission. Therefore, closer monitoring of transmission trends of drug resistant strains should be considered as priority, to ensure a successful TB control programme.

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Section: Discussioncontrasting

confidence: 94%

Anti-tuberculosis drug resistance and associated risk factors in a tertiary level TB center in Iran: a retrospective analysis

Merza

Farnia

Tabarsi

et al. 2011

J Infect Dev Ctries

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“…The epidemic of MDR TB is especially severe in China, a nation with the world's second largest number of TB cases and the largest number of MDR TB cases (39). A recent study reported that 9.3% of all TB cases in China are MDR, almost twice the worldwide MDR prevalence (4.8%) (14). While a lot of attention has been focused on acquired drug resistance among TB patients who receive an inadequate treatment regimen or who cannot adhere to their treatment regimen, several studies also showed that a large number of MDR TB cases are likely caused by transmission of MDR strains of Mycobacterium tuberculosis (2,19).…”

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Selection of Mutations To Detect Multidrug-Resistant Mycobacterium tuberculosis Strains in Shanghai, China

Luò

Zhao

et al. 2010

Antimicrob Agents Chemother

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Novel tools are urgently needed for the rapid, reliable detection of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of Mycobacterium tuberculosis. To develop such tools, we need information about the frequency and distribution of the mycobacterial mutations and genotypes that are associated with phenotypic drug resistance. In a population-based study, we sequenced specific genes of M. tuberculosis that were associated with resistance to rifampin and isoniazid in 242 phenotypically MDR isolates and 50 phenotypically pan-susceptible isolates from tuberculosis (TB) cases in Shanghai, China. We estimated the sensitivity and specificity of the mutations, using the results of conventional, culture-based phenotypic drug susceptibility testing as the standard. We detected mutations within the 81-bp core region of rpoB in 96.3% of phenotypically MDR isolates. Mutations in two structural genes (katG and inhA) and two regulatory regions (the promoter of mabA-inhA and the intergenic region of oxyR-ahpC) were found in 89.3% of the MDR isolates. In total, 88.0% (213/242 strains) of the phenotypic MDR strains were confirmed by mutations in the sequenced regions. Mutations in embB306 were also considered a marker for MDR and significantly increased the sensitivity of the approach. Based on our findings, an approach that prospectively screens for mutations in 11 sites of the M. tuberculosis genome (rpoB531, rpoB526, rpoB516, rpoB533, and rpoB513, katG315, inhA-15, ahpC-10, ahpC-6, and ahpC-12, and embB306) could detect 86.8% of MDR strains in Shanghai. This study lays the foundation for the development of a rapid, reliable molecular genetic test to detect MDR strains of M. tuberculosis in China.Multidrug-resistant (MDR) tuberculosis (TB), defined as resistance to at least rifampin (RIF) and isoniazid (INH), and extensively drug-resistant (XDR) TB, defined as additional resistance to any fluoroquinolone and one injectable secondline drug, are among the most serious health threats of the 21st century. The epidemic of MDR TB is especially severe in China, a nation with the world's second largest number of TB cases and the largest number of MDR TB cases (39). A recent study reported that 9.3% of all TB cases in China are MDR, almost twice the worldwide MDR prevalence (4.8%) (14). While a lot of attention has been focused on acquired drug resistance among TB patients who receive an inadequate treatment regimen or who cannot adhere to their treatment regimen, several studies also showed that a large number of MDR TB cases are likely caused by transmission of MDR strains of Mycobacterium tuberculosis (2, 19). Therefore, there is an urgent need for new tools and approaches that will provide a rapid, reliable, and cost-effective diagnosis of MDR TB, particularly in resource-limited settings. This will help to prevent transmission of MDR strains and to optimize treatment regimens for MDR cases.Drug susceptibility testing by the conventional solid medium culture method is highly sensitive and specific but extremely ...

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“…Drug resistance surveys among TB patients in 10 provinces of China from 1996 to 2004 were reported recently (8); however, Guizhou Province was not included. Our recent survey results indicated that the Zunyi area of Guizhou Province had a high prevalence of MDR-TB among newly treated (8.1%) and previously treated (45.1%) TB cases (2).…”

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confidence: 99%

Genetic Diversity and Drug Susceptibility of Mycobacterium tuberculosis Isolates from Zunyi, One of the Highest-Incidence-Rate Areas in China

Chen

Liu

et al. 2012

J Clin Microbiol

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Prevalence of tuberculosis drug resistance in 10 provinces of China

Abstract: Background: The emergence of drug-resistant tuberculosis (TB) hampers TB control. Ten provinces in China performed drug resistance surveys among tuberculosis (TB) patients in 1996-2004 to assess levels of drug resistance.

Cited by 58 publications

References 3 publications

Anti-tuberculosis drug resistance and associated risk factors in a tertiary level TB center in Iran: a retrospective analysis

Anti-tuberculosis drug resistance and associated risk factors in a tertiary level TB center in Iran: a retrospective analysis

Selection of Mutations To Detect Multidrug-Resistant Mycobacterium tuberculosis Strains in Shanghai, China

Genetic Diversity and Drug Susceptibility of Mycobacterium tuberculosis Isolates from Zunyi, One of the Highest-Incidence-Rate Areas in China

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