Open AccessDrug resistance and epidemiology characteristics of multidrug-resistant tuberculosis patients in 17 provinces of China
Author(s) -
Zhenhui Lu,
W. Jiang,
Jing Zhang,
Henry Lynn,
Yue Chen,
Shaoyan Zhang,
Zifeng Ma,
Ping Geng,
Xiaofan Guo,
Huiyong Zhang,
Zhijie Zhang
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0225361
Subject(s) - tuberculosis , medicine , extensively drug resistant tuberculosis , drug resistance , epidemiology , multiple drug resistance , levofloxacin , multi drug resistant tuberculosis , disease , amikacin , beijing , china , mycobacterium tuberculosis , antibiotics , pathology , biology , geography , microbiology and biotechnology , archaeology
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.