Cargando…

Epidemiology of anti-tuberculosis drug resistance in a chinese population: current situation and challenges ahead

BACKGROUND: Drug resistance has been a cause of concern for tuberculosis (TB) control in both developed and developing countries. Careful monitoring of the patterns and trends of drug resistance should remain a priority. METHODS: Strains were collected from 1824 diagnosed sputum smear positive pulmo...

Descripción completa

Detalles Bibliográficos
Autores principales: Shao, Yan, Yang, Dandan, Xu, Weiguo, Lu, Wei, Song, Honghuan, Dai, Yaoyao, Shen, Hongbing, Wang, Jianming
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045946/
https://www.ncbi.nlm.nih.gov/pubmed/21324205
http://dx.doi.org/10.1186/1471-2458-11-110
_version_ 1782198891692687360
author Shao, Yan
Yang, Dandan
Xu, Weiguo
Lu, Wei
Song, Honghuan
Dai, Yaoyao
Shen, Hongbing
Wang, Jianming
author_facet Shao, Yan
Yang, Dandan
Xu, Weiguo
Lu, Wei
Song, Honghuan
Dai, Yaoyao
Shen, Hongbing
Wang, Jianming
author_sort Shao, Yan
collection PubMed
description BACKGROUND: Drug resistance has been a cause of concern for tuberculosis (TB) control in both developed and developing countries. Careful monitoring of the patterns and trends of drug resistance should remain a priority. METHODS: Strains were collected from 1824 diagnosed sputum smear positive pulmonary TB patients in Jiangsu province of China and then tested for drug susceptibility against rifampicin, isoniazid, ethambutol and streptomycin. The prevalence and patterns of drug resistance in mycobacterium tuberculosis (MTB) isolates were investigated. Multiple logistic regression analysis was performed to identify the risk factors for multidrug resistant (MDR) bacterial infection. The strength of association was estimated by odds ratio (OR) and 95% confidence interval (95% CI). RESULTS: The drug susceptibility tests showed that 1077(59.05%) MTB strains were sensitive to all the four antibiotics and the other 747(40.95%) strains were resistant to at least one drug. The proportions of mono-drug resistance were 28.73% for isoniazid, 19.41% for rifampicin, 29.33% for streptomycin, and 13.98% for ethambutol, respectively. The prevalence of MDR-TB was 16.61%, which was significantly different between new cases (7.63%) and those with previous treatment history (33.07%). Geographical variation of drug resistance was observed, where the proportion of MDR-TB among new cases was higher in the central (9.50%) or north part (9.57%) than that in the south area (4.91%) of Jiangsu province. The age of patients was significantly associated with the risk of drug resistance (P < 0.001) and the adjusted OR (95% CI) was 1.88(1.26-2.81) for patients aged 35-44 years when compared with those 65 years or older. Patients with previous treatment history had a more than 5-fold increased risk of MDR-TB (adjusted OR: 6.14, 95% CI: 4.61-8.17), compared with those previously not having been treated. CONCLUSIONS: The high prevalence of drug resistance has been a major challenge for TB control. Prevention and control of drug-resistant TB should be emphasized by the revised DOTS (direct observed therapy, short course) program through prompt case detection, routine and quality-assured drug susceptibility test for patients at high risk of resistance, programmatic treatment with both first and second-line medicines, and systematic treatment observation, with priority for high MDR-TB settings.
format Text
id pubmed-3045946
institution National Center for Biotechnology Information
language English
publishDate 2011
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-30459462011-03-01 Epidemiology of anti-tuberculosis drug resistance in a chinese population: current situation and challenges ahead Shao, Yan Yang, Dandan Xu, Weiguo Lu, Wei Song, Honghuan Dai, Yaoyao Shen, Hongbing Wang, Jianming BMC Public Health Research Article BACKGROUND: Drug resistance has been a cause of concern for tuberculosis (TB) control in both developed and developing countries. Careful monitoring of the patterns and trends of drug resistance should remain a priority. METHODS: Strains were collected from 1824 diagnosed sputum smear positive pulmonary TB patients in Jiangsu province of China and then tested for drug susceptibility against rifampicin, isoniazid, ethambutol and streptomycin. The prevalence and patterns of drug resistance in mycobacterium tuberculosis (MTB) isolates were investigated. Multiple logistic regression analysis was performed to identify the risk factors for multidrug resistant (MDR) bacterial infection. The strength of association was estimated by odds ratio (OR) and 95% confidence interval (95% CI). RESULTS: The drug susceptibility tests showed that 1077(59.05%) MTB strains were sensitive to all the four antibiotics and the other 747(40.95%) strains were resistant to at least one drug. The proportions of mono-drug resistance were 28.73% for isoniazid, 19.41% for rifampicin, 29.33% for streptomycin, and 13.98% for ethambutol, respectively. The prevalence of MDR-TB was 16.61%, which was significantly different between new cases (7.63%) and those with previous treatment history (33.07%). Geographical variation of drug resistance was observed, where the proportion of MDR-TB among new cases was higher in the central (9.50%) or north part (9.57%) than that in the south area (4.91%) of Jiangsu province. The age of patients was significantly associated with the risk of drug resistance (P < 0.001) and the adjusted OR (95% CI) was 1.88(1.26-2.81) for patients aged 35-44 years when compared with those 65 years or older. Patients with previous treatment history had a more than 5-fold increased risk of MDR-TB (adjusted OR: 6.14, 95% CI: 4.61-8.17), compared with those previously not having been treated. CONCLUSIONS: The high prevalence of drug resistance has been a major challenge for TB control. Prevention and control of drug-resistant TB should be emphasized by the revised DOTS (direct observed therapy, short course) program through prompt case detection, routine and quality-assured drug susceptibility test for patients at high risk of resistance, programmatic treatment with both first and second-line medicines, and systematic treatment observation, with priority for high MDR-TB settings. BioMed Central 2011-02-17 /pmc/articles/PMC3045946/ /pubmed/21324205 http://dx.doi.org/10.1186/1471-2458-11-110 Text en Copyright ©2011 Shao et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Shao, Yan
Yang, Dandan
Xu, Weiguo
Lu, Wei
Song, Honghuan
Dai, Yaoyao
Shen, Hongbing
Wang, Jianming
Epidemiology of anti-tuberculosis drug resistance in a chinese population: current situation and challenges ahead
title Epidemiology of anti-tuberculosis drug resistance in a chinese population: current situation and challenges ahead
title_full Epidemiology of anti-tuberculosis drug resistance in a chinese population: current situation and challenges ahead
title_fullStr Epidemiology of anti-tuberculosis drug resistance in a chinese population: current situation and challenges ahead
title_full_unstemmed Epidemiology of anti-tuberculosis drug resistance in a chinese population: current situation and challenges ahead
title_short Epidemiology of anti-tuberculosis drug resistance in a chinese population: current situation and challenges ahead
title_sort epidemiology of anti-tuberculosis drug resistance in a chinese population: current situation and challenges ahead
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045946/
https://www.ncbi.nlm.nih.gov/pubmed/21324205
http://dx.doi.org/10.1186/1471-2458-11-110
work_keys_str_mv AT shaoyan epidemiologyofantituberculosisdrugresistanceinachinesepopulationcurrentsituationandchallengesahead
AT yangdandan epidemiologyofantituberculosisdrugresistanceinachinesepopulationcurrentsituationandchallengesahead
AT xuweiguo epidemiologyofantituberculosisdrugresistanceinachinesepopulationcurrentsituationandchallengesahead
AT luwei epidemiologyofantituberculosisdrugresistanceinachinesepopulationcurrentsituationandchallengesahead
AT songhonghuan epidemiologyofantituberculosisdrugresistanceinachinesepopulationcurrentsituationandchallengesahead
AT daiyaoyao epidemiologyofantituberculosisdrugresistanceinachinesepopulationcurrentsituationandchallengesahead
AT shenhongbing epidemiologyofantituberculosisdrugresistanceinachinesepopulationcurrentsituationandchallengesahead
AT wangjianming epidemiologyofantituberculosisdrugresistanceinachinesepopulationcurrentsituationandchallengesahead