Drug resistance of 218 isolates of Mycobacterium tuberculosis in

doi:10.3969/j.issn.1673-8640.2019.05.008

Abstract

Abstract:

Objective To analyze the drug resistance and risk factors of 218 isolates of Mycobacterium tuberculosis （MTB） in Xi'an. Methods A total of 218 isolates of MTB from 227 smear positive tuberculosis patients' sputum samples were collected in a surveillance point of Xi'an. The proportional method was used for the drug susceptibility test of 9 anti-tuberculosis drugs. Multivariate Logistic regression analysis was used to analyze the risk factors. Results The overall drug resistance rate was 32.57% （29.03% for the initial treatment cases and 53.13% for the retreatment cases）. The multi-drug resistance rate was 6.88%. The drug resistance rates to first-line and second-line anti-tuberculosis drugs were 25.69% and 15.14%,respectively. It showed the highest resistance to streptomycin （SM）,followed by isoniazid （INH）,rifampicin （RFP）,ethambutol （EMB）,ofloxacin （OFX）,capreomycin （CM）,p-aminosalicylic acid（PAS）,kanamycin （KM） and protionamide （PTO）. There were 29 types of drug resistance,including 6 cases of mono-drug resistance,3 cases of poly-drug resistance,7 cases of multi-drug resistance,11 cases of second-line drug resistance and 2 cases of other drug resistance. The drug resistance rate and multi-drug resistance rate in retreatment group were higher than those in initial treatment group [odds ratio （OR） =3.39,95% confidence interval（CI）1.49-7.70,χ²=8.52,P=0.004;OR=4.83,95%CI 1.53-15.25,χ²=7.21,P=0.01]. The multi-drug resistance rate in the group of annual family income less than 40 thousand was higher than that of corresponding control group （OR=3.96,95%CI 1.31-11.97,χ²=5.94,P=0.02）. Conclusions The overall drug resistance rate and multi-drug resistance rate of pulmonary tuberculosis patients in Xi'an are lower than those of the whole nation. The drug resistant spectrum has polymorphism and complexity. The drug retreatment patients are more likely to have drug resistance and multi-drug resistance,and low family income patients are more likely to have multi-drug resistance.

Key words: Pulmonary tuberculosis, Mycobacterium tuberculosis, Drug resistance, Risk factor, Xi'an city

CLC Number:

R446.1

Xi'an YANG Jian, ZHANG Tianhua, XIAN Xiaoping, LI Yan, CHEN Meiling, WANG Rui. Drug resistance of 218 isolates of Mycobacterium tuberculosis in[J]. Laboratory Medicine, 2019, 34(5): 421-427.

Figures/Tables 5

References 19

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组别	总株数	总耐药				单耐药
组别	总株数	株数	耐药率（%）		95%CI		株数	耐药率（%）	95%CI
初治组	186	54	29.03^*		22.50~35.56		26	13.98	9.00~18.96
复治组	82	17	53.13		35.84~70.42		8	25	10.00~40.00
合计	218	71	32.57		26.36~38.78		34	15.6	10.78~20.42
组别	多耐药			耐多药			广泛耐药
组别	株数	耐药率（%）	95%CI	株数	耐药率（%）	95%CI	株数	耐药率（%）	95%CI
初治组	9	4.84	1.76~7.92	9	4.84^*	1.76~7.92	0	0	0.00~1.95
复治组	0	0	0.00~10.94	6	18.75	5.23~32.27	1	3.13	0.08~16.26
合计	9	4.13	1.48~6.78	15	6.88	3.53~10.23	1	0.46	0.01~2.51

组别	总株数	总耐药				单耐药
组别	总株数	株数	耐药率（%）		95%CI		株数	耐药率（%）	95%CI
初治组	186	54	29.03^*		22.50~35.56		26	13.98	9.00~18.96
复治组	82	17	53.13		35.84~70.42		8	25	10.00~40.00
合计	218	71	32.57		26.36~38.78		34	15.6	10.78~20.42
组别	多耐药			耐多药			广泛耐药
组别	株数	耐药率（%）	95%CI	株数	耐药率（%）	95%CI	株数	耐药率（%）	95%CI
初治组	9	4.84	1.76~7.92	9	4.84^*	1.76~7.92	0	0	0.00~1.95
复治组	0	0	0.00~10.94	6	18.75	5.23~32.27	1	3.13	0.08~16.26
合计	9	4.13	1.48~6.78	15	6.88	3.53~10.23	1	0.46	0.01~2.51

组别	株数	总耐药[株（%）]	任一耐药
组别	株数	总耐药[株（%）]	INH[株（%）]	RFP[株（%）]	SM[株（%）]	EMB[株（%）]
初治组	186	42（22.58）^*	25（13.44）	15（8.06）^*	32（17.20）^*	5（2.69）^*
复治组	32	14（43.75）	7（21.88）	9（28.13）	11（34.38）	4（12.5）
合计	218	56（25.69）	32（14.68）	24（11.01）	43（19.72）	9（4.13）

组别	株数	总耐药[株（%）]	任一耐药
组别	株数	总耐药[株（%）]	INH[株（%）]	RFP[株（%）]	SM[株（%）]	EMB[株（%）]
初治组	186	42（22.58）^*	25（13.44）	15（8.06）^*	32（17.20）^*	5（2.69）^*
复治组	32	14（43.75）	7（21.88）	9（28.13）	11（34.38）	4（12.5）
合计	218	56（25.69）	32（14.68）	24（11.01）	43（19.72）	9（4.13）

组别	株数	总耐药[株（%）]	任一耐药
组别	株数	总耐药[株（%）]	OFX[株（%）]	KM[株（%）]	CM[株（%）]	PTO[株（%）]	PAS[株（%）]
初治组	186	21（11.29）^*	9（4.84）^*	4（2.15）^*	9（4.84）	0（0.00）	8（4.30）
复治组	32	12（37.50）	9（28.13）	4（12.50）	3（9.38）	0（0.00）	1（3.13）
合计	218	33（15.14）	18（8.26）	8（3.67）	12（5.50）	0（0.00）	9（4.13）