title: [Epidemic status of drug-resistant Mycobacterium tuberculosis in Shandong province, China].
abstract: OBJECTIVE
  To analyze the present epidemic status of drug-resistant Mycobacterium tuberculosis (MTB) in Shandong Province of China, as compared with findings of survey for drug-resistant MTB in 1997, and therefore to provide valuable data for making the current control policy of drug-resistant MTB.
  
  
  METHODS
  From October 2004 to December 2011, the culture positive sputum samples of all 5916 new registered sputum smear-positive TB patients at the county-level TB dispensaries were tested for drug susceptibility. Finally 5542 cases with test results were included in the analysis. Of the total cases, 4198 were male and 1344 were female. The age range of the patients were 15 to 92 years old and the average age was (51 ± 20) years old, among whom, 1304 were ≤ 29 years old, 2106 were from 30 to 59 years old and 2132 were ≥ 60 years old. Of all the cases, 4332 (78.2%) only received initial treatment and 1210 (21.8%) received retreatment. The SPSS 13.0 was used for statistical analysis and χ(2) test was used to compare category, gender, and age groups of patients.
  
  
  RESULTS
  The total drug resistance (TDR) rate was 19.4% (1075/5542), which was lower than 23.4% (288/1229) in 1997 in Shandong Province (χ(2) = 10.193, P < 0.01). The rates of single drug resistance (SDR), multidrug resistance (MDR) and poly-drug resistance (PDR) were 11.3% (629/5542), 3.7% (203/5542) and 4.4% (243/5542), respectively. The TDR rate in patients with initial treatment was 19.0% (822/4332), and 62.7% (515/822) of which was SDR. The TDR rate of patients with retreatment was 20.9% (253/1210), and 54.9% (139/253) of which tended to be MDR or PDR. Among TDR patients, those with initial treatment accounted for 76.5% (822/1075) and SDR patients accounted for 58.5% (629/1075). The MDR rate of patients with initial treatment was 2.9% (124/4332) and the rate of patients with retreatment was 6.5% (79/1210), the differences being significant (χ(2) = 36.032, P < 0.01). The TDR rate, initial TDR rate, and retreatment TDR rate in males were 19.9% (834/4198), 19.5% (641/3287), and 21.2% (193/911), respectively, as compared to 17.9% (241/1344), 17.3% (181/1045), and 20.1% (60/299) in females, the differences being not significant (χ(2) = 0.170-2.452, P > 0.05).
  
  
  CONCLUSIONS
  The drug-resistant TB control work in Shandong Province has made great achievements in recent years. However, patients with initial treatment were more likely to have drug-resistant MTB. Therefore the future control work should focus on early detection, effective treatment and management to control the spread of drug-resistant MTB.
authors.affiliation: Center for Tuberculosis Control and Prevention, Shandong Provincial Chest hospital, Jinan 250101, China.
authors.forename: Yong-wen
authors.initials: YW
authors.lastname: Li
authors.forename: Xin-xu
authors.initials: XX
authors.lastname: Li
authors.forename: Hong
authors.initials: H
authors.lastname: Geng
authors.forename: Wu-wei
authors.initials: WW
authors.lastname: Tao
authors.affiliation: Katharine Hsu International Research Center of Human Infectious Disease, Shandong Provincial Chest Hospital, Jinan 250013, China, Email: 13505412137@139.com.
authors.forename: Chun-bao
authors.initials: CB
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology* / Q000382:microbiology*; D055815:Young Adult