Abstract：The objective of this study was to investigate the prevalence of drug-resistant tuberculosis in Hangzhou county. Drug sensitivity testing and species identification were performed on 1975 cultured strains isolated from patients diagnosed with pulmonary tuberculosis in seven suburban counties of Hangzhou from January 2018 to December 2019, with the concentration proportional method and PNB/TCH growth experiments, respectively. The drug resistance spectrum and drug resistance rate were statistically analyzed. Among 1 731 Mycobacterium tuberculosis (M. tuberculosis) strains, 18.26% (316/1 731) were resistant to at least one tested drug. The drug resistance rates of first line drugs, second line drugs, single drugs, multi-drug resistance, MDR-TB, XDR-TB and rifampicin resistance were 14.96% (259/1 731), 4.97% (86/1 731), 11.84% (205/1 731), 3.81% (66/1 731), 2.60% (45/1 731), 0.06% (1/1 731) and 3.24% (56/1 731), respectively. A total of 28 drug resistance spectra were found among the 1 731 strains. No significant difference was observed in drug resistance rates between untreated and retreated patients. The total drug resistance rate and the drug resistance rates in untreated and retreated patients receiving first-line drugs, and the total drug resistance rate and the drug resistance rate in untreated patients with MDR-TO be, all decreased significantly in the periods of 2011, 2015 and 2018-2019. The total drug resistance rate and untreated patient drug resistance rate for the second-line drug ofloxacin showed a prominent increase after 2015. The proportions of patients with TB older than 60 years and the drug resistance rate of patients with TB 40-60 years of age were highest. The drug resistance rates differed among the seven suburban counties. In conclusion, from 2011 to 2019, the drug resistance rate of patients with TB at designated tuberculosis hospitals in suburban counties of Hangzhou decreased each year; thus, current tuberculosis prevention and control measures are effective. In the future, close attention should be paid to treatment and control in drug-resistant patients in counties with high drug resistance rates and drug-resistant patients 40-60 years of age; moreover, prevention and control of tuberculosis in older populations should be strengthened.
[1] World Health Organization.Global tuberculosis report [R]. Geneva: WHO,2021. [2] World Health Organization.Global tuberculosis report [R]. Geneva:WHO,2020. [3] Li QC, Zhao G, Wu LM, et al.Prevalence and patterns of drug resistance among pulmonary tuberculosis patients in Hangzhou, China[J]. Antimicrob Resist Infect Control, 2018,7:61. DOI: 10.1186/s13756-018-0348-7 [4] 贾庆军,谢立, 吴亦斐,等. 杭州市结核病患者耐药检测结果分析[J]. 预防医学,2019,31(3):289-292. DOI:10.19485/j.cnki.issn2096-5087.2019.03.017 [5] 赵雁林,逄宇. 结核病实验室检验规程[M].北京:人民卫生出版社,2015:59. [6] 中华人民共和国卫生部.WS288-2017,肺结核诊断[S].北京:中国标准出版社,2017. [7] 中国防痨协会. 耐药结核病化学治疗指南(2015)[J].中国防痨杂志,2015,37(5):421-469. [8] Zhou M, Liu S, Li QF, et al.Drug resistance characteristics of Mycobacterium tuberculosis isolates between 2014 and 2017 in Sichuan, China: a retrospective study[J]. PLoS One, 2018,13(12):e0209902. DOI: 10.1371/journal.pone.0209902 [9] Lan Y, Li Y, Chen L, et al.Drug resistance profiles and trends in drug-resistant tuberculosis at a major hospital in Guizhou Province of China[J]. Infect Drug Resist, 2019,12:211-219. DOI: 10.2147/IDR.S188538 [10] Zhou M, Liu S, Li Q, et al.Drug resistance characteristics of Mycobacterium tuberculosis isolates between 2014 and 2017 in Sichuan, China: a retrospective study[J]. PLoS One, 2018,13(12): e0209902. DOI: 10.1371/journal.pone.0209902 [11] Li Y, Cao X, Li S, et al.Characterization of Mycobacterium tuberculosis isolates from Hebei, China: genotypes and drug susceptibility phenotypes[J]. BMC Infect Dis, 2016, 16:107. DOI: 10.1186/s12879-016-1441-2 [12] Liu Y, Zhang X, Zhang, Y, et al.Characterization of Mycobacterium tuberculosis strains in Beijing, China: drug susceptibility phenotypes and Beijing genotype family transmission[J]. BMC Infect Dis, 2018,18(1):658. DOI: 10.1186/s12879-018-3578-7 [13] Yang C, Luo T, Shen X, et al.Transmission of multidrug-resistant Mycobacterium tuberculosis in Shanghai, China: a retrospective observational study using whole-genome sequencing and epidemiological investigation[J]. Lancet Infect Dis, 2017,17(3):275-284. DOI: 10.1016/S1473-3099(16)30418-2 [14] 杨健,张天华, 鲜小萍,等. 2017—2018年陕西省涂阳肺结核患者临床分离株的耐药性检测结果分析[J].中国防痨杂志,2019,41(06):616-623. DOI:10.3969/j.issn.1000-6621.2019.06.006 [15] 白大鹏, 孔伟利, 张丽霞. 2006—2017年天津市结核分枝杆菌耐药性分析[J]. 中华医院感染学杂志, 2019, 29(3):346-350. DOI: 10.11816/cn.ni.2019-180719 [16] Nsofor CA, Jiang Q, Wu J, et al.Transmission is a noticeable cause of resistance among treated tuberculosis patients in shanghai, China[J]. Sci Rep,2017,7:7691.DOI: 10.1038/s41598-017-08061-3 [17] Huai P, Huang X, Cheng J, et al.Proportions and risk factors of developing multidrug resistance among patients with tuberculosis in China: a population-based case-control study[J]. Microb Drug Resist, 2016, 22(8):717-726. DOI: 10.1089/mdr.2015.0186 [18] 吴亦斐,赵刚,陈淑丹,等. 肺结核病原体和易感因素及结核分枝杆菌优势耐药谱分析[J]. 中国人兽共患病学报,2019,35(6): 480-486. DOI: 10.3969/j.issn.1002-2694.2019.00.101 [19] 国家卫生健康委员会疾病预防控制局,医政医管局, 基层卫生健康司,等. 中国结核病预防控制工作技术规范(2020版)[S]. 北京:国家卫生健康委员会,2020. [20] Liu Q, Zhu LM, Shao Y, et al.Rates and risk factors for drug resistance tuberculosis in Northeastern China[J]. BMC Public Health, 2013,13:1171. DOI: 10.1186/1471-2458-13-1171
2022, Vol. 38 
