Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2013

Open Access 01-12-2013 | Research article

Rates and risk factors for drug resistance tuberculosis in Northeastern China

Authors: Qiao Liu, Limei Zhu, Yan Shao, Honghuan Song, Guoli Li, Yang Zhou, Jinyan Shi, Chongqiao Zhong, Cheng Chen, Wei Lu

Published in: BMC Public Health | Issue 1/2013

Login to get access

Abstract

Background

Drug-resistant tuberculosis (TB) has emerged as a major challenge toward TB control and prevention. In Lianyungang city, the extent and trend of drug resistant TB is not well known. The objective of the survey was to assess drug resistance pattern of MTB and risk factors for drug resistant TB, including multidrug resistance tuberculosis (MDR-TB) in this area.

Methods

We performed drug susceptibility testing on Mycobacterium tuberculosis (MTB) isolates with first- and second-line anti-tuberculosis drugs of 1012 culture positive TB cases by using the proportion method, who were consecutively enrolled from January 2011 to December 2012 in Lianyungang city, China. The patterns of drug resistance in MTB were investigated and multiple logistic regression analysis was performed to assess the risk factors for drug resistant TB.

Results

Among the 1012 strains tested, 308 (30.4%) strains were resistant to at least one first-line drug; the prevalence of MDR-TB was 88 (8.7%), 5 (0.5%) strains were found to be extensively drug-resistant tuberculosis (XDR-TB). Female gender was a risk factor for MDR-TB (adjusted odds ratio (aOR) 1.763, 95% CI (1.060-2.934). The aged 28–54 years was significantly associated with the risk of MDR-TB with an aOR: 2.224, 95% CI (1.158-4.273) when compared with those 65 years or older. Patients with previous treatment history had a more than 7-fold increased risk of MDR-TB, compared with those never previously treated.

Conclusions

The burden of drug resistant TB cases is sizeable, which highlights an urgent need to reinforce control, detection and treatment strategies for drug resistant TB.
Appendix
Available only for authorised users
Literature
1.
2.
Zhao Y, Xu S, Wang L, Chin DP, Wang S, Jiang G, Xia H, Zhou Y, Li Q, Ou X: National survey of drug-resistant tuberculosis in China. N Engl J Med. 2012, 366 (23): 2161-2170.CrossRefPubMed
3.
Iwamoto T, Yoshida S, Suzuki K, Tomita M, Fujiyama R, Tanaka N, Kawakami Y, Ito M: Hypervariable loci that enhance the discriminatory ability of newly proposed 15‒loci and 24‒loci variable‒number tandem repeat typing method on Mycobacterium tuberculosis strains predominated by the Beijing family. FEMS Microbiol Lett. 2007, 270 (1): 67-74.CrossRefPubMed
4.
Glynn J, Vyonycky E, Fine P: Influence of sampling on estimates of clustering and recent transmission of Mycobacterium tuberculosis derived from DNA fingerprinting techniques. Am J Epidemiol. 1999, 149 (4): 366-371.CrossRefPubMed
5.
Organization WH: Multidrug and extensively drug-resistant TB (M/XDR-TB): 2010 global report on surveillance and response. 2010, Geneva: World Health Organization
6.
Chonde T, Basra D, Mfinanga S, Range N, Lwilla F, Shirima R, Van Deun A, Zignol M, Cobelens F, Egwaga S: National anti-tuberculosis drug resistance study in Tanzania. Int J Tuberc Lung Dis. 2010, 14 (8): 967-972.PubMed
7.
Yu C-C, Chang C-Y, Liu C-E, Shih L-F, Hsiao J-H, Chen C-H: Drug resistance pattern of <i> mycobacterium tuberculosis</i> complex at a Medical Center in Central Taiwan, 2003–2007. J Microbiol Immunol Infect. 2010, 43 (4): 285-290.CrossRefPubMed
8.
Shao Y, Yang D, Xu W, Lu W, Song H, Dai Y, Shen H, Wang J: Epidemiology of anti-tuberculosis drug resistance in a chinese population: current situation and challenges ahead. BMC Public Health. 2011, 11: 110-CrossRefPubMedPubMedCentral
9.
Liu Q, Yang D, Xu W, Wang J, Lv B, Shao Y, Song H, Li G, Dong H, Wan K, et al: Molecular typing of mycobacterium tuberculosis isolates circulating in Jiangsu Province, China. BMC Infect Dis. 2011, 11: 288-CrossRefPubMedPubMedCentral
10.
Li X, Wang H, Jing H, Wang Y, Yu C, Wang J, Liu Z, Graviss E, Ma X: Population-based surveillance of extensively drug-resistant tuberculosis in Shandong Province, China [Short communication]. Int J Tuberc Lung Dis. 2012, 16 (5): 612-614.PubMed
11.
Hu Y, Mathema B, Wang W, Hoffner S, Kreiswirth B, Xu B: Prevalence of multidrug-resistant pulmonary tuberculosis in counties with different duration of DOTS implementation in rural China. Microb Drug Resist. 2008, 14 (3): 227-232.CrossRefPubMed
12.
Shen X, DeRiemer K, Yuan Z-A, Shen M, Xia Z, Gui X, Wang L, Gao Q, Mei J: Drug-resistant tuberculosis in Shanghai, China, 2000–2006: prevalence, trends and risk factors. Int J Tuberc Lung Dis. 2009, 13 (2): 253-259.PubMedPubMedCentral
13.
Choi JC, Lim SY, Suh GY, Chung MP, Kim H, Kwon OJ, Lee NY, Park YK, Bai GH, Koh W-J: Drug resistance rates of Mycobacterium tuberculosis at a private referral center in Korea. J Korean Med Sci. 2007, 22 (4): 677-681.CrossRefPubMedPubMedCentral
14.
Chacón L, Laínez M, Rosales E, Mercado M, Caminero J: Evolution in the resistance of Mycobacterium tuberculosis to anti-tuberculosis drugs in Nicaragua. Int J Tuberc Lung Dis. 2009, 13 (1): 62-67.PubMed
15.
16.
Wright A, Zignol M, Van Deun A, Falzon D, Gerdes SR, Feldman K, Hoffner S, Drobniewski F, Barrera L, van Soolingen D: Epidemiology of antituberculosis drug resistance 2002–07: an updated analysis of the Global Project on Anti-Tuberculosis Drug Resistance Surveillance. Lancet. 2009, 373 (9678): 1861-1873.CrossRefPubMed
17.
Caminero J: Likelihood of generating MDR-TB and XDR-TB under adequate National Tuberculosis Control Programme implementation [Review article]. Int J Tuberc Lung Dis. 2008, 12 (8): 869-877.PubMed
18.
Dye C: Doomsday postponed? Preventing and reversing epidemics of drug-resistant tuberculosis. Nat Rev Microbiol. 2009, 7 (1): 81-87.CrossRefPubMed
19.
Kim H-R, Hwang SS, Kim HJ, Lee SM, Yoo C-G, Kim YW, Han SK, Shim Y-S, Yim J-J: Impact of extensive drug resistance on treatment outcomes in non-HIV-infected patients with multidrug-resistant tuberculosis. Clin Infect Dis. 2007, 45 (10): 1290-1295.CrossRefPubMed
20.
Banerjee R, Allen J, Westenhouse J, Oh P, Elms W, Desmond E, Nitta A, Royce S, Flood J: Extensively drug-resistant tuberculosis in California, 1993–2006. Clin Infect Dis. 2008, 47 (4): 450-457.CrossRefPubMed
21.
Jou R, Chiang CY, Huang WL: Distribution of the Beijing family genotypes of Mycobacterium tuberculosis in Taiwan. J Clin Microbiol. 2005, 43 (1): 95-100.CrossRefPubMedPubMedCentral
22.
Organization WH: Engaging all health care providers in TB control: guidance on implementing public-private mix approaches. 2006, Geneva: World Health Organization
23.
Yoshiyama T, Yanai H, Rhiengtong D, Palittapongarnpim P, Nampaisan O, Supawitkul S, Uthaivorawit W, Mori T: Development of acquired drug resistance in recurrent tuberculosis patients with various previous treatment outcomes. Int J Tuberc Lung Dis. 2004, 8 (1): 31-38.PubMed
24.
Lew W, Pai M, Oxlade O: Initial drug resistance and tuberculosis treatment outcomes. Ann Intern Med. 2008, 149: 123-134.CrossRefPubMed
25.
Mak A, Thomas A, del Granado M, Zaleskis R, Mouzafarova N, Menzies D: Influence of multidrug resistance on tuberculosis treatment outcomes with standardized regimens. Am J Respir Crit Care Med. 2008, 178 (3): 306-312.CrossRefPubMed
26.
Vashakidze L, Salakaia A, Shubladze N, Cynamon M, Barbakadze K, Kikvidze M, Papitashvili L, Nonikashvili M, Solomonia N, Bejanishvili N: Prevalence and risk factors for drug resistance among hospitalized TB patients in Georgia. Int J Tuberc Lung Dis. 2009, 13 (9): 1148-PubMedPubMedCentral
27.
Mdivani N, Zangaladze E, Volkova N, Kourbatova E, Jibuti T, Shubladze N, Kutateladze T, Khechinashvili G, del Rio C, Salakaia A: High prevalence of multidrug-resistant tuberculosis in Georgia. Int J Infect Dis. 2008, 12 (6): 635-CrossRefPubMedPubMedCentral
28.
Toungoussova O, Caugant D, Sandven P, Mariandyshev A, Bjune G: Drug resistance of Mycobacterium tuberculosis strains isolated from patients with pulmonary tuberculosis in Archangels, Russia. Int J Tuberc Lung Dis. 2002, 6 (5): 406-414.PubMed
29.
Lockman S, Kruuner A, Binkin NJ, Levina K, Wang YC, Danilovitsh M, Hoffner SE, Tappero JW: Clinical outcomes of Estonian patients with primary multidrug-resistant versus drug-susceptible tuberculosis. Clin Infect Dis. 2001, 32 (3): 373-380.CrossRefPubMed
30.
Chiang C, Chang C, Chang R, Li C, Huang R: Patient and health system delays in the diagnosis and treatment of tuberculosis in Southern Taiwan. Int J Tuberc Lung Dis. 2005, 9 (9): 1006-1012.PubMed
31.
Long NH, Johansson E, Lonnroth K, Eriksson B, Winkvist A, Diwan V: Longer delays in tuberculosis diagnosis among women in Vietnam. Int J Tuberc Lung Dis. 1999, 3 (5): 388-393.PubMed
32.
Jeon CY, Hwang SH, Min JH, Prevots DR, Goldfeder LC, Lee H, Eum SY, Jeon DS, Kang HS, Kim JH: Extensively drug‒resistant tuberculosis in South Korea: risk factors and treatment outcomes among patients at a tertiary referral hospital. Clin Infect Dis. 2008, 46 (1): 42-49.CrossRefPubMed
33.
Faustini A, Hall AJ, Perucci CA: Risk factors for multidrug resistant tuberculosis in Europe: a systematic review. Thorax. 2006, 61 (2): 158-163.CrossRefPubMed
34.
Law W, Yew W, Chiu Leung C, Kam K, Tam C, Chan C, Leung C: Risk factors for multidrug-resistant tuberculosis in Hong Kong. Int J Tuberc Lung Dis. 2008, 12 (9): 1065-1070.PubMed
35.
Barroso EC, Mota RMS, Santos RO, Sousa ALO, Barroso JB, Rodrigues JLN: Risk factors for acquired multidrug-resistant tuberculosis. J Pneumol. 2003, 29 (2): 89-97.CrossRef
36.
Gandhi NR, Moll A, Sturm AW, Pawinski R, Govender T, Lalloo U, Zeller K, Andrews J, Friedland G: Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa. Lancet. 2006, 368 (9547): 1575-1580.CrossRefPubMed
37.
Amor YB, Nemser B, Singh A, Sankin A, Schluger N: Underreported threat of multidrug-resistant tuberculosis in Africa. Emerg Infect Dis. 2008, 14 (9): 1345-CrossRefPubMedPubMedCentral
Metadata
Title
Rates and risk factors for drug resistance tuberculosis in Northeastern China
Authors
Qiao Liu
Limei Zhu
Yan Shao
Honghuan Song
Guoli Li
Yang Zhou
Jinyan Shi
Chongqiao Zhong
Cheng Chen
Wei Lu
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2013
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-13-1171

Other articles of this Issue 1/2013

BMC Public Health 1/2013 Go to the issue

Study protocol

The effectiveness of critical time intervention for abused women and homeless people leaving Dutch shelters: study protocol of two randomised controlled trials

Research article

Compliance and enforcement of a partial smoking ban in Lisbon taxis: an exploratory cross-sectional study

Research article

Outdoor advertising, obesity, and soda consumption: a cross-sectional study

Research article

Prevalence of latent tuberculosis infection in Sudan: a case–control study comparing interferon-γ release assay and tuberculin skin test

Research article

Nutritional status of children under 5 years of age in the Brazilian Western Amazon before and after the Interoceanic highway paving: a population-based study

Research article

Risk factors for pulmonary tuberculosis in Croatia: a matched case–control study