Analysis of drug resistance of <b><i>Mycobacterium tuberculosis</i></b> in West China Hospital of Sichuan University from 2016 to 2018 _West China Medical Journal

Authors：

DAI Zhongqiu , ZHANG Yuwei , Deng Jin , CHEN Zhixing , WU Siying , LIU Ya , DENG Jielun ,  XIE Yi

Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

XIE Yi, Email: xie_yi_77@163.com

Keywords：

Mycobacterium tuberculosis; Drug susceptibility testing; Drug resistance rate

DOI：

10.7507/1002-0179.201807044

Video：

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ObjectiveTo understand the drug resistance of Mycobacterium tuberculosis complex in West China Hospital, Sichuan University, analyze its drug resistance characteristics, and provide reference for the monitoring of drug-resistant tuberculosis.MethodsFrom January 2016 to March 2018, Mycobacterium tuberculosis drug susceptibility testing kit was used to detect the drug susceptibility of Mycobacterium tuberculosis culture-positive strains in Department of Laboratory Medicine, West China Hospital, Sichuan University. The tested drugs included four of the first-line anti-tuberculosis drugs: rifampicin, isoniazid, ethambutol, and streptomycin, and ten of the second-line anti-tuberculosis drugs: capreomycin, ofloxacin, ethionamide, p-aminosalicylic acid, levofloxacin, moxifloxacin, rifabutin, amikacin, kanamycin, and chlorine phenazine.ResultsA total of 130 patients (130 strains) were enrolled, including 82 newly diagnosed patients (82 strains) and 48 re-treated patients (42 strains). The drug resistance rate of the 130 patients was 37.69%. The drug resistance rate of the newly diagnosed patients (28.05%) was significantly lower than that of the re-treated patients (54.17%), and there was a statistical difference (χ²=8.794, P=0.003). The multi-drug resistance rate of the newly diagnosed patients (6.10%) was significantly lower than that of the re-treated patients (25.00%), and the difference was statistically significant (χ²=9.517, P=0.002). The resistance rate of isoniazid, rifampicin, and streptomycin in newly diagnosed patients (23.17%, 8.54%, and 7.32%, respectively) were significantly lower than those in the re-treated patients (45.83%, 41.67%, and 29.17%, respectively), and the differences were statistically significant (P<0.05). The resistance rate of ofloxacin, moxifloxacin, rifabutin and ethionamide in the newly diagnosed patients (9.76%, 8.54%, 7.31%, and 4.88%, respectively) were significantly lower than those in the re-treated patients (39.58%, 27.08%, 25.00%, and 22.92%, respectively), and the differences were statistically significant (P<0.05).ConclusionIt is necessary to strengthen the standardized treatment of patients with newly diagnosed tuberculosis, increase the treatment and management of re-treated tuberculosis patients, and prevent the generation and spread of drug-resistant patients, especially multidrug-resistant patients.

Citation： DAI Zhongqiu, ZHANG Yuwei, Deng Jin, CHEN Zhixing, WU Siying, LIU Ya, DENG Jielun, XIE Yi. Analysis of drug resistance of Mycobacterium tuberculosis in West China Hospital of Sichuan University from 2016 to 2018 . West China Medical Journal, 2018, 33(8): 984-988. doi: 10.7507/1002-0179.201807044 Copy

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1. World Health Organization. Global tuberculosis report 2012. Geneva: World Health Organization, 2012: 1-2. http://www.searo.who.int/publications/bookstore/documents/9241564504/en/.
2. 鄭揚, 趙雁林. 初、復治患者結核分枝桿菌臨床分離株對抗結核藥物耐藥性的分析. 醫學研究雜志, 2017, 46(4): 22-27.
3. 唐神結, 許紹發, 李亮, 等. 耐藥結核病學. 北京: 人民衛生出版社, 2014.
4. World Health Organization. Global tuberculosis report 2017. Geneva: World Health Organization, 2017: 1-262. http://www.who.int/tb/publications/global_report/en/.
5. 全國第五次結核病流行病學抽樣調查技術指導組, 全國第五次結核病流行病學抽樣調查辦公室. 2010 年全國第五次結核病流行病學抽樣調查報告. 中國防癆雜志, 2012, 34(8): 485-508.
6. 陳建, 楊光京, 羅槑. 四川地區結核分枝桿菌耐藥性和耐藥譜分析. 現代預防醫學, 2010, 37(17): 3211-3212.
7. 張文, 胡代玉, 劉英, 等. 重慶市 638 例肺結核患者耐藥流行現狀分析. 中國熱帶醫學, 2017, 17(3): 231-235.
8. 周云, 劉瑞, 杜永國, 等. 海南省 219 株耐藥結核分枝桿菌藥敏試驗結果分析. 現代預防醫學, 2017, 44(19): 3640-3644.
9. 中華人民共和國衛生部. 全國結核病耐藥性基線調查報告(2007—2008 年). 北京: 人民衛生出版社, 2010: 25-30.
10. 范常龍, 王博, 紀濱英. 105 例肺結核痰結核菌耐藥情況分析. 黑龍江醫藥, 2014, 27(4): 850-851.
11. 祝進, 陸軍, 余旭良, 等. 679 株結核分枝桿菌藥敏結果分析. 中國衛生檢驗雜志, 2012, 22(5): 1184-1185, 1188.
12. 梁慶福, 陳求揚, 趙永, 等. 福建省結核病耐藥性監測結果分析. 中國公共衛生, 2012, 28(4): 420-422.
13. 吳巨飛, 邵榮標, 劉偉. 534 株結核分枝桿菌藥敏試驗結果分析. 現代預防醫學, 2014, 41(7): 1334-1336.
14. 米熱班?熱夏提, 胡昕, 徐仰玲, 等. 新疆喀什地區 214 株結核分枝桿菌耐藥情況及菌型分析. 中國防癆雜志, 2012, 34(8): 538-541.
15. 譚衛國, 楊應周, 羅道泉, 等. 深圳市結核分枝桿菌耐藥監測疫情趨勢分析. 中華檢驗醫學雜志, 2005, 28(8): 805-806.
16. 鐘球, 錢明, 李建偉, 等. 廣東省 WHO 結核病耐藥監測研究. 中國防癆雜志, 2001, 23(1): 5-8.
17. 吳皖卿, 張堅華, 劉勤連, 等. 1976 例肺結核患者痰培養及其藥敏檢測的分析. 現代預防醫學, 2013, 40(19): 3687-3690.
18. 蘭萍, 劉梅, 李娜娜, 等. 74 例結核分枝桿菌耐藥情況分析. 中國現代醫生, 2018, 56(1): 130-132.

West China Medical Journal

Analysis of drug resistance of Mycobacterium tuberculosis in West China Hospital of Sichuan University from 2016 to 2018

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