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

Video：

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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. 中國醫療保健國際交流促進會臨床微生物與感染分會, 中華醫學會檢驗醫學分會臨床微生物學組, 中華醫學會微生物學和免疫學分會臨床微生物學組. 綜合醫院結核分枝桿菌感染實驗室檢查共識. 中華檢驗醫學雜志, 2022, 45(4): 343-353.
3. 徐彩紅, 周向梅, 范偉興, 等. 我國結核病防治主要成就回眸及亟待解決的問題與建議. 中國防癆雜志, 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. 趙雁林, 陳明亭, 中國疾病預防控制中心結核病預防控制中心. 中國結核病防治工作技術指南. 北京: 人民衛生出版社, 2021.
6. 王黎霞, 成詩明, 陳明亭, 等. 2010 年全國第五次結核病流行病學抽樣調查報告. 中國防癆雜志, 2012, 34(8): 485-508.
7. 高媛, 張書, 龍波, 等. 2018 年四川省 4865 例涂陽結核患者耐藥分析. 職業衛生與病傷, 2020, 35(5): 278-284.
8. 高媛, 張書, 龍波, 等. 2020 年四川省涂陽結核病初復治患者耐藥情況分析. 預防醫學情報雜志, 2022, 38(3): 301-306.
9. 戴仲秋, 張雨薇, 鄧勁, 等. 四川大學華西醫院 2016 年—2018 年結核分枝桿菌耐藥情況分析. 華西醫學, 2018, 33(8): 984-988.
10. 雷倩, 王皓, 呂小會, 等. 1201 例肺結核患者耐藥情況及影響因素分析. 華南預防醫學, 2021, 47(1): 1-5.
11. 吳聯朋. 1276 株結核分枝桿菌對一線抗結核藥物和部分耐多藥菌株對二線抗結核藥物的耐藥性分析. 中國衛生檢驗雜志, 2020, 30(22): 2729-2732.
12. 王東萍, 包訓迪, 梁鎖, 等. 2012—2019 年安徽某醫院結核分枝桿菌耐藥趨勢. 中華醫院感染學雜志, 2021, 31(19): 2925-2929.
13. 王珂, 喬博, 雷磊, 等. 2706 例結核分枝桿菌陽性患者的耐藥性分析. 中國衛生檢驗雜志, 2021, 31(23): 2914-2916, 2920.
14. 董春萍, 姚向陽, 楊映暉, 等. 廈門地區 504 株結核分枝桿菌對一線抗結核藥物的耐藥與耐多藥情況分析. 抗感染藥學, 2021, 18(8): 1098-1102.
15. 趙妮娜, 陳慧, 趙靜, 等. 蘇州地區 532 例結核病患者結核分枝桿菌對抗結核藥物的耐藥情況及其相關影響因素分析. 抗感染藥學, 2019, 16(10): 1683-1687.
16. 易俊莉, 楊新宇, 陳昊, 等. 1156 株結核分枝桿菌臨床分離株耐藥情況分析. 中國防癆雜志, 2021, 43(7): 677-681.
17. 邵燕, 宋紅煥, 李國莉, 等. 2013—2018 年江蘇省結核分枝桿菌耐藥性特征及趨勢分析. 江蘇預防醫學, 2021, 32(5): 515-518.
18. 馮鑫, 胡彥, 沈靜, 等. 2014-2019 年重慶市肺結核耐藥監測點結核分枝桿菌耐藥結果分析. 結核與肺部疾病雜志, 2021, 2(3): 251-255.
19. 趙朝珍, 卿敏, 劉喬虹, 等. 2015—2019 年南充市結核分枝桿菌耐藥情況及流行特征分析. 預防醫學情報雜志, 2022, 38(3): 314-318.
20. 李曉芬, 陳文杰. 2017~2019 年惠州市肺結核患者耐藥情況分析. 預防醫學論壇, 2021, 27(10): 778-779, 783.
21. 劉占鋒, 莊嚴, 王少華, 等. 2018—2020 年河南省 761 株結核分枝桿菌耐藥性分析. 河南預防醫學雜志, 2022, 33(7): 507-510, 555.
22. 林建, 林淑芳, 戴志松, 等. 福建省 2016—2019 年結核分枝桿菌耐藥趨勢分析. 海峽預防醫學雜志, 2021, 27(4): 54-57.
23. 宋敏, 陸普選, 方偉軍, 等. 2022 年 WHO 全球結核病報告: 全球與中國關鍵數據分析. 新發傳染病電子雜志, 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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