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Drug resistance and epidemiology characteristics of multidrug-resistant tuberculosis patients in 17 provinces of China


Autoři: Zhenhui Lu aff001;  Wenhan Jiang aff002;  Jing Zhang aff002;  Henry S. Lynn aff002;  Yue Chen aff003;  Shaoyan Zhang aff001;  Zifeng Ma aff001;  Peihua Geng aff001;  Xiaoyan Guo aff001;  Huiyong Zhang aff001;  Zhijie Zhang aff002
Působiště autorů: Department of Respiratory, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China aff001;  Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Xuhui District, Shanghai, People’s Republic of China aff002;  School of Epidemiology, Public Health and Preventive Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada aff003
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0225361

Souhrn

As China is one of high MDR-TB burden countries, it is important to determine the drug resistant pattern and clinical characteristics of multidrug resistant tuberculosis (MDR-TB). We conducted a comprehensive and nationwide study on MDR-TB in 17 provinces for the period from June 2009 to June 2015, and a total of 1154 cases of MDR-TB were finally investigated. The study sought to assess the clinical features and contrast drug susceptibility profiles of MDR-TB patients in China. Cavitary disease, young age, and long duration of TB disease among MDR-TB patients were important predictors. A high resistance proportion of first-line drugs was observed in Beijing, Shanghai and Tianjin. Resistant proportions of second-line anti-TB drugs in western region for amikacin, aminosalicylic acid, and levofloxacin were higher than eastern and central regions. High levels of drug resistance were seen in earlier cases (before 2011) and outpatients. We found high levels of resistance to 1st- and 2nd-line drugs in all settings, with considerable variabilities in terms of different Directly Observed Treatment Short Course (DOTS) programme, level of economic development(eastern, central and western regions) and patient source (inpatients and outpatients). Timely drug susceptibility testing (DST) and effective management are necessary to ensure an early detection of MDR-TB and its proper treatment.

Klíčová slova:

Drug therapy – Extensively drug-resistant tuberculosis – China – Multi-drug-resistant tuberculosis – Outpatients – Streptomycin – Tuberculosis – Tuberculosis diagnosis and management


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