title: Anti-tuberculosis drug resistance patterns and trends in a tuberculosis referral hospital, 1997-2009.
abstract: Information about the changing epidemiology of drug-resistant tuberculosis (TB) in hospitals in China over the past decade remains largely unknown. This study examined the susceptibility patterns and trends of drug-resistant TB cases in the 309 Hospital in Beijing, China. Mycobacterium tuberculosis isolates were retrospectively identified, drug susceptibility test (DST) results and clinical data were analysed for the period 1997-2009. Of the 5523 culture-positive TB patients, 47·1% had resistance to any anti-TB drug, 14·8% had mono-resistant TB, 19·8% had poly-resistant TB, 19·4% had multidrug-resistant TB (MDR-TB), and 1·3% had extensively drug-resistant TB (XDR-TB). Drug-resistant TB was significantly associated with age group, residential situation, and TB treatment history (P<0·001). During 1997-2000, the percentage of TB patients with any resistance, mono-resistant TB, poly-resistant TB, MDR-TB and XDR-TB all increased significantly (P<0·001). During 2000-2003, the increasing trends of MDR-TB and XDR-TB cases were reversed. During 2004-2009, the percentage of TB patients with any resistance, mono-resistant TB, poly-resistant TB, MDR-TB and XDR-TB all declined significantly (P<0·001), but the prevalence of MDR-TB and poly-resistant TB cases remained high. Our study provides evidence demonstrating that intensive TB control measures have helped reverse the increasing trends of drug-resistant TB in China, but continuous surveillance of drug-resistant TB and better case management are still needed to further reduce the remaining high prevalence of drug-resistant TB.
authors.affiliation: Institute for Tuberculosis Research, 309 Hospital, Beijing, China. cuihualiu@gmail.com
authors.forename: C H
authors.initials: CH
authors.lastname: Liu
authors.forename: H M
authors.initials: HM
authors.lastname: Li
authors.forename: L
authors.initials: L
authors.lastname: Li
authors.forename: Y L
authors.initials: YL
authors.lastname: Hu
authors.forename: Q
authors.initials: Q
authors.lastname: Wang
authors.forename: N
authors.initials: N
authors.lastname: Yang
authors.forename: S
authors.initials: S
authors.lastname: Wang
authors.forename: B
authors.initials: B
authors.lastname: Zhu
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D024881:Drug Resistance, Bacterial; D005260:Female; D006763:Hospitals, Chronic Disease; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D012189:Retrospective Studies; D014376:Tuberculosis / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents