Drug resistance of <i>Mycobacterium tuberculosis</i> in West China Hospital of Sichuan University from 2019 to 2022_West China Medical Journal

Authors：

XIONG Li , ZHOU Dan , LI Mengjiao , SHU Ling , WU Chongyang , LI Dongdong ,  XIE Yi

Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

XIE Yi, Email: xie_yi_77@163.com

Keywords：

Mycobacterium tuberculosis complex; comprehensive hospital; drug resistance

DOI：

10.7507/1002-0179.202310121

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Objective To analyze the drug resistance of Mycobacterium tuberculosis complex (MTBC) in West China Hospital of Sichuan University in recent years to provide reference for drug resistance monitoring and prevention strategies of tuberculosis in general hospitals. Methods The clinical strains of MTBC that performed drug susceptibility tests in West China Hospital of Sichuan University between January 2019 and December 2022 were collected. The drug susceptibility information of 13 anti-tuberculosis drugs, namely rifampicin, isoniazid, ethambutol, streptomycin, rifabutin, amikacin, kanamycin, ofloxacin, levofloxacin, moxifloxacin, para-aminosalicylic acid, ethionamide, and capreomycin, was collected and retrospectively analyzed. Results A total of 502 clinical strains of MTBC were included, and 366 of them were isolated from newly-treated patients while 136 form re-treated patients. The resistance rates of MTBC strains to the first-line anti-tuberculosis drugs in descending order were 28.69% (isoniazid), 19.72% (ethambutol), and 14.94% (rifampicin). Among the second-line drugs, the resistance rates to ofloxacin, levofloxacin, and moxifloxacin were 13.55%, 12.15%, and 11.95%, respectively. The resistance rates to amikacin, kanamycin, para-aminosalicylic acid, and ethionamide were all less than 10%. The resistance rates to streptomycin, capreomycin, and rifabutin were 17.53%, 13.55%, and 12.15%, respectively. The resistance rates to the remaining 12 anti-tuberculosis drugs except capreomycin of MTBC strains isolated from re-treated patients were higher than those of MTBC strains isolated from newly-treated patients, and the differences were statistically significant (P<0.05). The isolation rates of monodrug-resistant, polydrug-resistant, multidrug-resistant (MDR) and pre-extensively drug-resistant (pre-XDR) strains were 9.36%, 7.37%, 7.17%, and 7.77%, respectively. The isolation rates of strains with the four drug-resistant phenotypes generally showed a downward trend during the four years, and the changing trends were statistically significant (P<0.05). The isolation rates of MDR and pre-XDR strains from re-treated patients were higher than those from newly-treated patients, and the differences were statistically significant (P<0.001). Conclusion Tuberculosis drug resistance in West China Hospital of Sichuan University, which is a comprehensive tuberculosis-designated hospital, remained severe during the four years from 2019 to 2022, and the prevention of tuberculosis and the monitoring of drug resistance should be further strengthened.

Citation： XIONG Li, ZHOU Dan, LI Mengjiao, SHU Ling, WU Chongyang, LI Dongdong, XIE Yi. Drug resistance of Mycobacterium tuberculosis in West China Hospital of Sichuan University from 2019 to 2022. West China Medical Journal, 2024, 39(8): 1179-1183. doi: 10.7507/1002-0179.202310121 Copy

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1. World Health Organization. Global tuberculosis report 2022. Geneva: World Health Organization, 2022.
2. 中国医疗保健国际交流促进会临床微生物与感染分会, 中华医学会检验医学分会临床微生物学组, 中华医学会微生物学和免疫学分会临床微生物学组. 综合医院结核分枝杆菌感染实验室检查共识. 中华检验医学杂志, 2022, 45(4): 343-353.
3. 徐彩红, 周向梅, 范伟兴, 等. 我国结核病防治主要成就回眸及亟待解决的问题与建议. 中国防痨杂志, 2020, 42(12): 1263-1267.
4. World Health Organization. Technical manual for drug susceptibility testing of medicines used in the treatment of tuberculosis. Geneva: World Health Organization, 2018.
5. 赵雁林, 陈明亭, 中国疾病预防控制中心结核病预防控制中心. 中国结核病防治工作技术指南. 北京: 人民卫生出版社, 2021.
6. 王黎霞, 成诗明, 陈明亭, 等. 2010 年全国第五次结核病流行病学抽样调查报告. 中国防痨杂志, 2012, 34(8): 485-508.
7. 高媛, 张书, 龙波, 等. 2018 年四川省 4865 例涂阳结核患者耐药分析. 职业卫生与病伤, 2020, 35(5): 278-284.
8. 高媛, 张书, 龙波, 等. 2020 年四川省涂阳结核病初复治患者耐药情况分析. 预防医学情报杂志, 2022, 38(3): 301-306.
9. 戴仲秋, 张雨薇, 邓劲, 等. 四川大学华西医院 2016 年—2018 年结核分枝杆菌耐药情况分析. 华西医学, 2018, 33(8): 984-988.
10. 雷倩, 王皓, 吕小会, 等. 1201 例肺结核患者耐药情况及影响因素分析. 华南预防医学, 2021, 47(1): 1-5.
11. 吴联朋. 1276 株结核分枝杆菌对一线抗结核药物和部分耐多药菌株对二线抗结核药物的耐药性分析. 中国卫生检验杂志, 2020, 30(22): 2729-2732.
12. 王东萍, 包训迪, 梁锁, 等. 2012—2019 年安徽某医院结核分枝杆菌耐药趋势. 中华医院感染学杂志, 2021, 31(19): 2925-2929.
13. 王珂, 乔博, 雷磊, 等. 2706 例结核分枝杆菌阳性患者的耐药性分析. 中国卫生检验杂志, 2021, 31(23): 2914-2916, 2920.
14. 董春萍, 姚向阳, 杨映晖, 等. 厦门地区 504 株结核分枝杆菌对一线抗结核药物的耐药与耐多药情况分析. 抗感染药学, 2021, 18(8): 1098-1102.
15. 赵妮娜, 陈慧, 赵静, 等. 苏州地区 532 例结核病患者结核分枝杆菌对抗结核药物的耐药情况及其相关影响因素分析. 抗感染药学, 2019, 16(10): 1683-1687.
16. 易俊莉, 杨新宇, 陈昊, 等. 1156 株结核分枝杆菌临床分离株耐药情况分析. 中国防痨杂志, 2021, 43(7): 677-681.
17. 邵燕, 宋红焕, 李国莉, 等. 2013—2018 年江苏省结核分枝杆菌耐药性特征及趋势分析. 江苏预防医学, 2021, 32(5): 515-518.
18. 冯鑫, 胡彦, 沈静, 等. 2014-2019 年重庆市肺结核耐药监测点结核分枝杆菌耐药结果分析. 结核与肺部疾病杂志, 2021, 2(3): 251-255.
19. 赵朝珍, 卿敏, 刘乔虹, 等. 2015—2019 年南充市结核分枝杆菌耐药情况及流行特征分析. 预防医学情报杂志, 2022, 38(3): 314-318.
20. 李晓芬, 陈文杰. 2017~2019 年惠州市肺结核患者耐药情况分析. 预防医学论坛, 2021, 27(10): 778-779, 783.
21. 刘占锋, 庄严, 王少华, 等. 2018—2020 年河南省 761 株结核分枝杆菌耐药性分析. 河南预防医学杂志, 2022, 33(7): 507-510, 555.
22. 林建, 林淑芳, 戴志松, 等. 福建省 2016—2019 年结核分枝杆菌耐药趋势分析. 海峡预防医学杂志, 2021, 27(4): 54-57.
23. 宋敏, 陆普选, 方伟军, 等. 2022 年 WHO 全球结核病报告: 全球与中国关键数据分析. 新发传染病电子杂志, 2023, 8(1): 87-92.

West China Medical Journal

Drug resistance of Mycobacterium tuberculosis in West China Hospital of Sichuan University from 2019 to 2022

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