title: [A survey on resistance to second-line drugs in patients with pulmonary tuberculosis in Shanghai, China].
abstract: OBJECTIVE
  To determine the pattern of resistance to second-line drugs (SLDs) in patients with tuberculosis (TB) in Shanghai, China.
  
  
  METHODS
  All sputum culture positive patients detected at each district/county TB hospital/clinic in Shanghai during January to December 2009 were enrolled. First-line drug susceptibility testing was routinely performed for each clinical isolate. All clinical isolates with any resistance to first-line anti-TB drug were tested for second-line drug susceptibility.
  
  
  RESULTS
  Of the 431 TB patients with any resistance to first-line anti-TB drugs included in this study, 27.8% (120/431) were resistant to any SLDs tested. The rank of drug resistance was as follows: ofloxacin (68/431, 15.8%) > kanamycin (37/431, 8.6%) > para-aminosalicylic acid (35/431, 8.1%) > capreomycin (28/431, 6.5%) > amikacin (23/431, 5.3%) > prothionamide (8/431, 1.9%). Mono-resistance to SLD was the most predominant pattern. Among patients with resistance to SLD, the percentages of mono-resistance were 2/2, 20/36, 22/24 and 43/58 for rifampin-resistant group, isoniazid-resistant group, other-resistant group, and MDR group, respectively.
  
  
  CONCLUSIONS
  The high prevalence of resistance to SLDs in TB patients suggests the necessity to strengthen the TB control program for drug-resistant TB in Shanghai.
authors.affiliation: Department of TB Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Shen
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.forename: Qian
authors.initials: Q
authors.lastname: Gao
authors.forename: Biao
authors.initials: B
authors.lastname: Xu
authors.forename: Jian
authors.initials: J
authors.lastname: Mei
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents