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High incidence of drug‐resistant Mycobacterium tuberculosis in Hainan Island, China
Author(s) -
Lin Mingguan,
Zhong Yeteng,
Chen Zhuolin,
Lin Chong,
Pei Hua,
Shu Wei,
Pang Yu
Publication year - 2019
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13285
Subject(s) - ethambutol , medicine , tuberculosis , drug resistance , isoniazid , streptomycin , incidence (geometry) , mycobacterium tuberculosis , population , ofloxacin , extensively drug resistant tuberculosis , multiple drug resistance , antibiotics , microbiology and biotechnology , environmental health , biology , pathology , ciprofloxacin , physics , optics
Objectives To assess the proportion of drug‐resistant tuberculosis ( TB ) cases and to identify independent risk factors associated with drug‐resistant TB in Hainan. Methods Descriptive analysis of demographic and clinical data of culture‐positive TB patients to assess the trends in drug‐resistant TB at the Provincial Clinical Center on Tuberculosis of Hainan between 2014 and 2017. Results 994 patients were recruited into the study. Overall, the proportion of patients resistant to at least one TB drug tested was 36.1% (359/994). The most frequent resistance was to isoniazid ( INH , 29.8%), followed by rifampin ( RIF , 29.3%), streptomycin (19.3%), ofloxacin ( OFX , 17.4%), ethambutol (9.5%) and kanamycin ( KAN , 3.2%). Of 291 RIF ‐resistant isolates, 228 (78.4%) were also resistant to INH , while the remaining 63 (21.6%) were susceptible to INH . Among those with multidrug‐resistant tuberculosis ( MDR ‐ TB ), 41.2% had additional resistance to OFX and 3.9% to KAN . 8.8% of MDR ‐ TB patients were affected by extensively drug‐resistant ( XDR ‐ TB ). Females were more likely to infected with MDR ‐ TB than males, and young people (<20 years old) were more likely to have MDR ‐ TB ; patients exhibited decreasing MDR ‐ TB risk with increasing age. Conclusions Our data provide the first primary understanding of the drug‐resistant TB epidemic in Hainan. The high incidence of drug resistance, especially RIF and FQ resistance, highlight the importance of interventions for preventing epidemics of drug‐resistant TB . Younger age is an independent predictor of MDR ‐ TB , reflecting the potential transmission in this population.