Objective To investigate the prevalence of primary drug-resistant tuberculosis(TB) and associated risk factors in China. We also explored factors contributing to the transmission of multidrug-resistant tuberculosis...Objective To investigate the prevalence of primary drug-resistant tuberculosis(TB) and associated risk factors in China. We also explored factors contributing to the transmission of multidrug-resistant tuberculosis(MDR-TB). Methods A total of 2794 representative, Mycobacterium tuberculosis isolates from treatment-naive patients were subjected to drug susceptibility testing, and risk factors for drug-resistant TB were analyzed. We also analyzed MDR-TB strain sublineages, drug-resistance-conferring mutations, and risk factors associated with clustered primary MDR strains. Results Among 2794 Mycobacterium tuberculosis isolates from treatment-naive patients, the prevalence of any resistance to first-line drugs was 33.2% and the prevalence of MDR-TB was 5.7%. We did not find any risk factors significantly associated with resistance to first-line drugs. The 93 primary MDR-TB isolates were classified into six sublineages, of which, 75(80.6%) isolates were the RD105-deleted Beijing lineage. The largest sublineage included 65(69.9%) isolates with concurrent deletions of RD105, RD207, and RD181. Twenty-nine(31.2%) primary MDR strains grouped in clusters; MDR isolates in clusters were more likely to have S531 L rpoB mutation. Conclusion This study indicates that primary drug-resistant TB and MDR-TB strains are prevalent in China, and multiple measures should be taken to address drug-resistant TB.展开更多
基金supported by a research grant from the National Science & Technology Major Project (2014ZX10003001001) and (2014ZX10003002)
文摘Objective To investigate the prevalence of primary drug-resistant tuberculosis(TB) and associated risk factors in China. We also explored factors contributing to the transmission of multidrug-resistant tuberculosis(MDR-TB). Methods A total of 2794 representative, Mycobacterium tuberculosis isolates from treatment-naive patients were subjected to drug susceptibility testing, and risk factors for drug-resistant TB were analyzed. We also analyzed MDR-TB strain sublineages, drug-resistance-conferring mutations, and risk factors associated with clustered primary MDR strains. Results Among 2794 Mycobacterium tuberculosis isolates from treatment-naive patients, the prevalence of any resistance to first-line drugs was 33.2% and the prevalence of MDR-TB was 5.7%. We did not find any risk factors significantly associated with resistance to first-line drugs. The 93 primary MDR-TB isolates were classified into six sublineages, of which, 75(80.6%) isolates were the RD105-deleted Beijing lineage. The largest sublineage included 65(69.9%) isolates with concurrent deletions of RD105, RD207, and RD181. Twenty-nine(31.2%) primary MDR strains grouped in clusters; MDR isolates in clusters were more likely to have S531 L rpoB mutation. Conclusion This study indicates that primary drug-resistant TB and MDR-TB strains are prevalent in China, and multiple measures should be taken to address drug-resistant TB.