Drug-Resistant Pulmonary Tuberculosis among Adolescents and Young Adults in China

To determine the proportions of drug-resistant tuberculosis (TB), its trends, and the drug resistance-conferring mutations among patients with pulmonary TB aged 10-24 years in China.

The data of patients with pulmonary TB were retrieved from a national drug-resistant TB survey for analysis. Joinpoint regression software was used to analyze time trends. We also used whole genome sequencing to analyze the lineages and drug resistance-conferring mutations of 621 isolates.

Among 4,235 patients with pulmonary TB, the proportion of new cases of multidrug-resistant tuberculosis (MDR-TB) was 3.18% (95% confidence interval [ CI]: 2.37-4.15) for adolescents and 3.76% (95% CI: 3.03-4.60) for young adults; for previously treated patients, MDR-TB accounted for 11.25% (95% CI: 5.28-20.28) of adolescents and 11.05% (95% CI: 6.88-16.55) of young adults. The proportion of patients with MDR-TB remained stable among both new and previously treated patients aged 10-24 years during the study period. Through whole genome sequencing, we found that the most common mutations in the MDR-TB strains were Ser315Thr in the katG gene (71.74%) and Ser450Leu in the rpoB gene (50.00%).

This study revealed a high proportion of MDR-TB among adolescents and young adults, indicating that urgent and comprehensive measures are needed to reduce the emergence and transmission of drug-resistant TB among this population in China.