Declining prevalence of multidrug-resistant but comparatively high quinolone-resistant tuberculosis in Heilongjiang Province, China: 2013–2022 trend
摘要
The spread of multidrug-resistant tuberculosis (MDR-TB) remains a major problem globally. China is the high-burden country for TB, TB/HIV and MDR/rifampicin-resistant TB (RR-TB) in the period 2021–2025. Heilongjiang Province, located in the northeast of China and is the border region with the Russian Federation, which is also a high-burden country for TB/HIV and MDR/RR-TB. Heilongjiang Province had a higher prevalence of TB and MDR-TB than many other areas of China based on data 2007–2012(Li D, et al. BMC Infect Dis. 2016.16:516). The high prevalence may affect the epidemic of TB and drug-resistant TB in China as well as in Russia. Therefore, the knowledge about the patterns of drug resistance in this TB high-burden area of China is crucial to develop appropriate control strategies. This study is a continuation of an analysis of the drug-resistant TB epidemic in this area, 2013–2022.
MethodsA total of 11,139 Mycobacterium tuberculosis (M. tuberculosis) clinical isolates were collected from 11,139 hospitalized patients with TB from 2013 to 2022. The sensitivity of the isolates to first- and second-line antituberculosis drugs was investigated. We also compared the two methods for drug susceptibility testing (DST), including absolute concentration and liquid rapid culture.
ResultsThe prevalence of drug-resistant TB to any first-line drug and second-line drug was 38.9% and 31.0%, respectively. The prevalence of MDR-TB (8.5% in 2013–2022 vs. 22.8% in 2007–2012) has significantly declined. However, the prevalence of levofloxacin(Lfx)-resistant-TB (13.5% in 2013–2022 vs. 10.4% in 2010–2012) has increased. The trends of resistance to the first- and the second-line drugs in 2022 slightly increased compared to those in 2020 and 2021. The prevalence of pre-extensive drug-resistant TB (pre-XDR-TB, resistant to rifampicin and any of fluoroquinolones) was relatively high (7.6%).
ConclusionsThe maintenance of a high prevalence of fluoroquinolone-resistant and pre-XDR-TB remains a serious threat to public health and has an impact on TB control to achieve China’s goal of TB elimination. Therefore, continuous surveillance of the spread of drug-resistant TB in this border region is important.