Analysis of the Results of Tuberculosis Drug Resistance Surveillance in Yuexiu District, Guangzhou City, 2013–2022

Introduction

The objectives of the study are to understand the drug-resistant situation and trend of tuberculosis patients in Yuexiu District, Guangzhou City, from 2013 to 2022, and to provide a scientific basis for the development of rational drug-resistant tuberculosis prevention and control strategies in Guangzhou City.

Methods

All patients who were diagnosed with active tuberculosis in Guangzhou Chest Hospital from January 1, 2013 to December 31, 2022 were collected as study subjects, and a total of 5191 patients were enrolled in the study. Comprehensive data on the basic characteristics, diagnostic, and therapeutic information of the study subjects were collected. Sputum specimens were subjected to smear, isolation, and culture. Culture-positive strains of bacteria were identified by bacterial groups. A total of 1659 strains of Mycobacterium tuberculosis (MTB) isolates were obtained. The drug susceptibility test was carried out using the proportionality method on the MTB isolates for nine types of antituberculosis medicines: isoniazid (INH), rifampicin (RFP), ethambutol (EMB), streptomycin (Sm), kanamycin (Km), ofloxacin (Ofx), capreomycin (Cm), propylthioisonicotinamide (Pto), and p-aminosalicylic acid (PAS). A comparative analysis of the resistance patterns among the strains was conducted.

Results

A total of 1659 patients with MTB were cultured, revealing 438 drug-resistant cases. Among these, 255 were monoresistant, 121 were polyresistant, and 62 were multidrug resistant. The overall resistance rate was 26.40% (438/1659), with mono-resistance rate at 15.37% (255/1659), polyresistance rate at 7.29% (121/1659), and multidrug resistance rate at 3.74% (62/1659). In descending order, the resistance rates of MTB isolates to any of the nine antituberculosis drugs were Sm (12.24%, 203/1659), INH (9.22%, 153/1659), EMB (7.35%, 122/1659), RFP (6.99%, 116/1659), PAS (3.25%, 54/1659), Pto (3.13%, 52/1659), Ofx (2.71%, 45/1659), Cm (2.17%, 36/1659), and Km (2.17%, 36/1659). The differences in resistance rates were statistically significant (p < 0.01), with Sm exhibiting the highest resistance rate and Km the lowest.

In the primary treatment group, 388 patients (25.55%) were drug resistant, while 50 patients (35.46%) in the retreatment group were drug resistant. Thirty-nine patients (2.57%) in the primary treatment group were multidrug resistant, compared to 23 patients (16.31%) in the retreatment group. The resistance rate and multidrug resistance rate of isolates from retreatment patients were significantly higher than primary treatment patients (p < 0.05).

Conclusions

The problem of drug-resistant tuberculosis transmission in Guangzhou requires attention, and drug-resistant screening should be further increased to effectively control the source of infection.