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Trends and Characteristics of Drug-Resistant Tuberculosis: A Five-Year Study at a Major Specialized Hospital in
Jin Huang1,2, Xianjin Cao1, Mingdong Wang3
1The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, Guizhou Province, People's Republic of China.
Purpose:
Drug-resistant tuberculosis (DR-TB), particularly multidrug-resistant (MDR-TB) and rifampicin-resistant TB (RR-TB), poses a major public health challenge. In Guizhou Province, a high-burden region for tuberculosis (TB) in China, data on long-term drug resistance profile characteristics and trends remain limited. This study aimed to characterize the epidemiological patterns, drug resistance profiles, and temporal trends of DR-TB in Guizhou Province from 2018 to 2023.
Patients And Methods:
This retrospective study included 9,389 hospitalized pulmonary TB patients from the Guiyang Public Health Clinical Center. Sociodemographic and phenotypic drug susceptibility testing data were extracted from laboratory databases. Trend chi-square tests and multivariate logistic regression were used to analyze resistance trends and identify risk factors for MDR/RR-TB.
Results:
Among 9,389 patients, 2,669 (28.43%) had DR-TB. Resistance rates to the four first-line anti-TB drugs were: isoniazid 16.92%, rifampicin 12.46%, streptomycin 11.81%, and ethambutol 5.27%. For second-line drugs, rates were: moxifloxacin 5.02%, para-aminosalicylic acid 4.96%, levofloxacin 4.58%, kanamycin 2.89%, capreomycin 2.62%, clofazimine 1.84%, amikacin 1.51%, and protionamide 1.04%. The prevalence of RR-TB, MDR-TB, and pre-extensively drug-resistant TB (Pre-XDR-TB) was 12.46%, 10.05%, and 2.62%, respectively. Significant increasing trends were observed for resistance to rifampicin, fluoroquinolones (levofloxacin/moxifloxacin), and clofazimine. The most common resistance patterns were MDR2 (INH+RIF, 7.68%) and PDR2 (INH+SM, 5.36%). MDR/RR-TB cases clustered geographically in Guiyang and Bijie. Significant risk factors included age 19-39 years (AOR=1.520, 95% CI: 1.026-2.252), unemployment (AOR=1.330, 95% CI: 1.103-1.604), and prior TB treatment (AOR=6.422, 95% CI: 5.533-7.454).
Conclusion:
From 2018 to 2023, the prevalence of RR-TB, MDR-TB, and fluoroquinolone-resistant TB increased markedly in Guizhou Province. To reduce the incidence and spread of MDR/RR-TB, future efforts should strengthen prevention and control measures for DR-TB in vulnerable populations including young and middle-aged adults, the unemployed, and individuals with previous treatment failures as well as in high-risk locations.
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