Trends of Rifampicin Resistance in Patients with Pulmonary Tuberculosis: A Longitudinal Analysis Based on Drug Resistance Screening in Eastern China Between 2015 and 2019

Abstract

To understand the trend of overall rifampicin resistance rates for tuberculosis in Zhejiang Province between 2015 and 2019. Methods: The basic demographic information of patients with tuberculosis who were screened for drug resistance in Zhejiang Province between January 1, 2015 and December 31, 2019 was collected through the national Tuberculosis Information Management System. The data were processed and analyzed using IBM SPSS 26.0 and GeoDa 1.14 software. Results:The total rifampicin resistance rate was 5.9% in 53,893 validated cases of drug resistance screening conducted in patients with pulmonary tuberculosis in Zhejiang Province during the study period. There was a decreasing trend in the rifampicin resistance rate in both initial and re-treated patients (P<0.001), but the rifampicin resistance rate was higher in re-treated TB patients than in TB patients receiving their initial treatment (11.4% vs 4.2%). The rate of drug resistance steadily decreased in all prefectures, and there was a significant upward trend in the use of the Xpert MTB/RIF rapid assay. An increasing trend was also identified in the rate of rifampicin and ofloxacin co-resistance (P<0.001). Conclusion:The overall rate of rifampin resistance in patients with tuberculosis in Zhejiang Province in the past five years has shown a decreasing trend, but the rate of resistance to ofloxacin was high. Resistance testing to fluoroquinolones should be carried out as early as possible in patients whose diagnosis results indicate rifampin resistance, and more effective second-line treatment plans should be developed based on the results of this testing.

Prevalence of Rifampicin resistance tuberculosis among presumptive tuberculosis patients in Egypt-2021: A National Health Facility-based Survey

“…by Gautam et al [11] (26.1%) and Mondal et al [12] (8.91%). In addition, other countries in Asia, showed higher prevalence of RR as in Pakistan [13] (10.2%), Philippines [14] (19.3%), China [15] (5.9%). The difference between our rate and the previous rates may be due to that India and China are countries with high TB burden while Egypt is one of the low/middle TB burden countries.…”

“…However, this association disappeared in the multivariate model. Various studies worldwide have established that previous treatment with anti-tuberculosis therapy is a major risk factor for RR-TB resistance [11,13,15,[17][18][19][24][25][26]. This can be explained by poor compliance, lack of supervision, weak TB control program with interrupted drug supply, inadequate TB treatment, receiving wrong medical prescription, and unsatisfactory compliance by TB patients and physicians [13,18,24,26,36].…”

Spatial spillover effect of environmental factors on the tuberculosis occurrence among the elderly: a surveillance analysis for nearly a dozen years in eastern China

“…This method allows detection of the MTB complex in less than two hours, promoting early identification and treatment of PTB cases and reducing the transmission of PTB among elderly people [ 20 ]. This also explains the successive increase in the proportion of pathogen positivity since 2017 [ 21 ]. Furthermore, the coronavirus disease pandemic led to an excessive reduction in PTB detection and case notification at early stage, which may have also caused an underestimation of the notification rate in recent years [ 22 ].…”