Rates and risk factors for drug resistance tuberculosis in Northeastern China

Abstract

BackgroundDrug-resistant tuberculosis (TB) has emerged as a major challenge toward TB control and prevention. In Lianyungang city, the extent and trend of drug resistant TB is not well known. The objective of the survey was to assess drug resistance pattern of MTB and risk factors for drug resistant TB, including multidrug resistance tuberculosis (MDR-TB) in this area.MethodsWe performed drug susceptibility testing on Mycobacterium tuberculosis (MTB) isolates with first- and second-line anti-tuberculosis drugs of 1012 culture positive TB cases by using the proportion method, who were consecutively enrolled from January 2011 to December 2012 in Lianyungang city, China. The patterns of drug resistance in MTB were investigated and multiple logistic regression analysis was performed to assess the risk factors for drug resistant TB.ResultsAmong the 1012 strains tested, 308 (30.4%) strains were resistant to at least one first-line drug; the prevalence of MDR-TB was 88 (8.7%), 5 (0.5%) strains were found to be extensively drug-resistant tuberculosis (XDR-TB). Female gender was a risk factor for MDR-TB (adjusted odds ratio (aOR) 1.763, 95% CI (1.060-2.934). The aged 28–54 years was significantly associated with the risk of MDR-TB with an aOR: 2.224, 95% CI (1.158-4.273) when compared with those 65 years or older. Patients with previous treatment history had a more than 7-fold increased risk of MDR-TB, compared with those never previously treated.ConclusionsThe burden of drug resistant TB cases is sizeable, which highlights an urgent need to reinforce control, detection and treatment strategies for drug resistant TB.

Risk Factors for Drug-Resistant Tuberculosis

“…Previous TB treatment, a well-known risk factor for drug-resistant TB [7] [9]- [11] [14] [15] was also found to be significantly associated with drug resistance in the present study. Although drug-resistant TB can be transmitted between individuals (primary resistance), most cases arise after inadequate treatment allowing a drug-resistant strain to become dominant [10].…”

Drug Resistance Pattern in Pulmonary Tuberculosis Patients and Risk Factors Associated with Multi-Drug Resistant Tuberculosis

“…The studies from Ethiopia reported the proportion of resistance to RIF was in range of 0% -1.9% [15]. Similarly, the higher rate (5.9%) of RIF monoresistance was reported from Northeastern China [25]. In the similar study conducted in Nepal, monoresistance to INH, RIF, EMB and SM was 9.31%, 3.1%, 0.62% and 19.25% respectively [26].…”

“…It could be due to poor nutritional status of women because women compromise their own nutrition in order to ensure other family members are adequately nourished. The similar survey conducted at Northeastern China showed females are more likely to suffer from TB than males [25] but another similar study showed male gender was at the higher risk of MDR-TB [30]. Some studies have also reported previous treatment and age group 24 -54 years to be risk factors of MDR-TB [25] [30].…”

Diagnostic Value of GeneChip for Detection of Resistant Mycobacterium tuberculosis in Patients with Differing Treatment Histories

“…The MDR-TB prevalence rate in previously treated cases is higher than that in new TB cases around the world. In our study area, there are more than six times as many previously treated cases as new cases (19). The PPV usually reaches above 90% in drug resistance diagnostic assays only when the prevalence of resistance is above 15% (18,28).…”

“…As a parallel test, p-nitrobenzoic acid (PNB) was utilized for nontuberculous mycobacterium (NTM) identification. Growth in LJ medium containing PNB indicates that the bacilli do not belong to the M. tuberculosis complex (19). For internal quality assurance of DST, a standard H37Rv strain was included with each new batch of LJ medium, and DST was also performed when reading was done after 4 and after 6 weeks.…”