title: [Prevalence and risk factors on the resistance related to second-line drugs among multi-drug resistant tuberculosis cases in Shanghai, China].
abstract: OBJECTIVE
  To determine the prevalence and risk factors on second-line drug resistance in patients with multidrug resistant tuberculosis (MDR-TB) in Shanghai, China.
  
  
  METHODS
  All pulmonary TB patients with sputum culture positivity detected in Shanghai during January to December, 2009, were enrolled. All of the pretreatment sputum-positive cultures samples were tested for routine specimen identification and routine drug susceptibility testing for first-line drugs (Isoniazid, Rifampin, Ethambutol and Streptomycin). Drug susceptibility testing on second-line anti-TB drugs (Ofloxacin, Amikacin, Kanamycin, Capreomycin, P-aminosalicylic acid and Prothionamide) was routinely performed on isolates of Mycobacterium (M.) TB with MDR. Logistic regression analysis was conducted to determine the risk factors regarding second-line drug resistance.
  
  
  RESULTS
  A total of 1867 patients infected with M. TB isolates were diagnosed at the TB hospitals/clinics in Shanghai during the study period, of whom 112 (6.0%) were MDR-TB, in which 58 cases (51.8%) showed resistant to at least one of the second-line drugs tested and 10 cases belonged to extensively drug-resistant. In the multivariate analyses, MDR-TB patients who were aged 45 - 59 years (aOR = 4.76, P = 0.001), with sputum smear positivity (aOR = 6.51, P = 0.026) were significantly more likely to show resistance to second-line drugs.
  
  
  CONCLUSIONS
  The prevalence of second-line drug resistance among MDR-TB patients was high in Shanghai. MDR-TB patients who were under age of 45 - 59 years and with sputum smear positivity would represent important common risk factors for the resistance to second-line drugs.
authors.affiliation: Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.forename: Yang-yi
authors.initials: YY
authors.lastname: Zhang
authors.forename: Xiao-hong
authors.initials: XH
authors.lastname: Gui
authors.forename: Zheng-an
authors.initials: ZA
authors.lastname: Yuan
authors.forename: Qi-chao
authors.initials: QC
authors.lastname: Pan
authors.forename: Jian
authors.initials: J
authors.lastname: Mei
authors.forename: Xin
authors.initials: X
authors.lastname: Shen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000494:pharmacology; D002681:China / Q000453:epidemiology; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification; D015995:Prevalence; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology* / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents