Ning Han, Libo Yan, Man Yuan, Zhu Chen, Yilan Zeng, Hong Tang
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Multivariable logistic regression analysis was used to assess risk factors for MDR-TB based on patients' treatment history, age, sex, ethnicity, health facility, living environment and human immunodeficiency virus (HIV) status.</p><p><strong>Results: </strong>Among the 5180 participants, resistance was highest for isoniazid (23.59%), followed by rifampin (18.42%), streptomycin (18.42%) and ethambutol (2.47%). The prevalence of MDR-TB was 774 (14.94%) among all cases, with 575 (14.20%) in newly diagnosed tuberculosis (TB) patients and 199 (17.60%) in previously treated patients. Additionally, 17 (0.33%) patients were diagnosed with MDR-TB. Furthermore, urban living was identified as a protective factor against MDR-TB (odds ratio [OR] 0.80, 95% confidence interval [CI] 0.68-0.94, p = 0.004). Notably, individuals younger than 60 were more likely to develop MDR-TB, especially those aged 32-45 (OR 2.22, 95% CI 1.74-2.83, p < 0.001). In addition, HIV-positive status was identified as a risk factor for MDR-TB (OR 2.06, 95% CI 1.21-3.49, p = 0.008).</p><p><strong>Conclusions: </strong>The study demonstrated that the prevalence of DR-TB among the study subjects exceeded the national level. Patients living in rural areas, those with a history of TB treatment, HIV-positive individuals, and younger patients were more likely to develop MDR-TB.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":" ","pages":"704-711"},"PeriodicalIF":2.6000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Characteristics and risk factors of drug-resistant tuberculosis in Sichuan, China: An observational study.\",\"authors\":\"Ning Han, Libo Yan, Man Yuan, Zhu Chen, Yilan Zeng, Hong Tang\",\"doi\":\"10.1111/tmi.14126\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>This study aimed to determine the epidemiological characteristics of drug-resistant tuberculosis (DR-TB) and investigate the risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in Sichuan, China.</p><p><strong>Methods: </strong>The study involved 5180 clinical isolates collected from Sichuan since 2013, with non-tuberculous mycobacteria excluded. Drug susceptibility testing was conducted using four first-line anti-TB drugs, fluoroquinolones, and second-line injectable agents. Multivariable logistic regression analysis was used to assess risk factors for MDR-TB based on patients' treatment history, age, sex, ethnicity, health facility, living environment and human immunodeficiency virus (HIV) status.</p><p><strong>Results: </strong>Among the 5180 participants, resistance was highest for isoniazid (23.59%), followed by rifampin (18.42%), streptomycin (18.42%) and ethambutol (2.47%). The prevalence of MDR-TB was 774 (14.94%) among all cases, with 575 (14.20%) in newly diagnosed tuberculosis (TB) patients and 199 (17.60%) in previously treated patients. Additionally, 17 (0.33%) patients were diagnosed with MDR-TB. Furthermore, urban living was identified as a protective factor against MDR-TB (odds ratio [OR] 0.80, 95% confidence interval [CI] 0.68-0.94, p = 0.004). 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引用次数: 0
摘要
目的:了解四川省耐药结核病(DR-TB)的流行病学特征,探讨与耐多药结核病(MDR-TB)相关的危险因素。方法:选取2013年以来四川省临床分离的5180株结核分枝杆菌,不包括非结核分枝杆菌。采用4种一线抗结核药物、氟喹诺酮类药物和二线注射药物进行药敏试验。基于患者的治疗史、年龄、性别、种族、卫生设施、生活环境和人类免疫缺陷病毒(HIV)状况,采用多变量logistic回归分析评估耐多药结核病的危险因素。结果:5180名受试者中异烟肼耐药率最高(23.59%),其次是利福平(18.42%)、链霉素(18.42%)和乙胺丁醇(2.47%);耐多药结核病患病率为774例(14.94%),其中新诊断结核病患者575例(14.20%),既往治疗患者199例(17.60%)。此外,17例(0.33%)患者被诊断为耐多药结核病。此外,城市生活被确定为耐多药结核病的保护因素(优势比[OR] 0.80, 95%可信区间[CI] 0.68-0.94, p = 0.004)。值得注意的是,60岁以下的个体更容易发生耐多药结核病,特别是32-45岁的个体(OR 2.22, 95% CI 1.74-2.83, p)。结论:研究表明,研究对象中耐多药结核病的患病率超过了全国水平。生活在农村地区的患者、有结核病治疗史的患者、艾滋病毒阳性个体和年轻患者更有可能发生耐多药结核病。
Characteristics and risk factors of drug-resistant tuberculosis in Sichuan, China: An observational study.
Objectives: This study aimed to determine the epidemiological characteristics of drug-resistant tuberculosis (DR-TB) and investigate the risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in Sichuan, China.
Methods: The study involved 5180 clinical isolates collected from Sichuan since 2013, with non-tuberculous mycobacteria excluded. Drug susceptibility testing was conducted using four first-line anti-TB drugs, fluoroquinolones, and second-line injectable agents. Multivariable logistic regression analysis was used to assess risk factors for MDR-TB based on patients' treatment history, age, sex, ethnicity, health facility, living environment and human immunodeficiency virus (HIV) status.
Results: Among the 5180 participants, resistance was highest for isoniazid (23.59%), followed by rifampin (18.42%), streptomycin (18.42%) and ethambutol (2.47%). The prevalence of MDR-TB was 774 (14.94%) among all cases, with 575 (14.20%) in newly diagnosed tuberculosis (TB) patients and 199 (17.60%) in previously treated patients. Additionally, 17 (0.33%) patients were diagnosed with MDR-TB. Furthermore, urban living was identified as a protective factor against MDR-TB (odds ratio [OR] 0.80, 95% confidence interval [CI] 0.68-0.94, p = 0.004). Notably, individuals younger than 60 were more likely to develop MDR-TB, especially those aged 32-45 (OR 2.22, 95% CI 1.74-2.83, p < 0.001). In addition, HIV-positive status was identified as a risk factor for MDR-TB (OR 2.06, 95% CI 1.21-3.49, p = 0.008).
Conclusions: The study demonstrated that the prevalence of DR-TB among the study subjects exceeded the national level. Patients living in rural areas, those with a history of TB treatment, HIV-positive individuals, and younger patients were more likely to develop MDR-TB.
期刊介绍:
Tropical Medicine & International Health is published on behalf of the London School of Hygiene and Tropical Medicine, Swiss Tropical and Public Health Institute, Foundation Tropical Medicine and International Health, Belgian Institute of Tropical Medicine and Bernhard-Nocht-Institute for Tropical Medicine. Tropical Medicine & International Health is the official journal of the Federation of European Societies for Tropical Medicine and International Health (FESTMIH).