Persistently high prevalence of primary resistance and multidrug resistance of tuberculosis in Heilongjiang Province, China.
BACKGROUND
The spread of multidrug-resistant tuberculosis (MDR-TB) Mycobacterium tuberculosis (M. tuberculosis) strains has been a big challenge to the TB control and prevention in China. Knowledge about patterns of drug resistance in TB high-burden areas of China is crucial to develop appropriate control strategies. We conducted a comprehensive investigation of the resistance pattern of M. tuberculosis in Heilongjiang Province.


METHODS
1427 M. tuberculosis clinical strains were isolated from pulmonary TB patients hospitalized between 2007 and 2012. The susceptibility of the isolates to the first-line anti-TB drugs and the resistance of MDR M. tuberculosis to fluoroquinolones were examined. We also performed a statistical analysis to identify the correlated risk factors for high burden of MDR-TB.


RESULTS
The global resistance rates of 2007-2012 to the first-line drugs and MDR were 57.0 and 22.8 %, respectively. Notably, the primary MDR-TB and pan-resistance rates were as high as 13.6 and 5.0 %, respectively. Of MDR M. tuberculosis isolates (2009), approximately 13 % were not susceptible to any of the fluoroquinolones tested. Being age of 35 to 54, high re-treatment proportion, the presence of cavity lesion, and high proportion of shorter hospitalization are correlated with the development of MDR-TB.


CONCLUSIONS
The high prevalence of drug resistant, MDR-TB, and fluoroquinolone-resistant MDR-TB is a big concern for TB control. More importantly, in order to control the development of MDR-TB effectively, we need to pay more attention to the primary resistance. Targeting reducing the prevalence of the risk factors may lead to better TB control in China.
Department of Microbiology; Wu Lien-Teh Institute, Harbin Medical University, Harbin, China.|Heilongjiang Provincial Key Laboratory of Infection and Immunity, Harbin, China.
Di
D
Li
Department of Microbiology; Wu Lien-Teh Institute, Harbin Medical University, Harbin, China.
Jing-Li
JL
Wang
Harbin Chest Hospital, Harbin, China.
Bin-Ying
BY
Ji
Department of Microbiology; Wu Lien-Teh Institute, Harbin Medical University, Harbin, China.
Jia-Yi
JY
Cui
Department of Microbiology; Wu Lien-Teh Institute, Harbin Medical University, Harbin, China.
Xin-Ling
XL
Pan
Harbin Chest Hospital, Harbin, China.
Chang-Long
CL
Fan
Department of Microbiology; Wu Lien-Teh Institute, Harbin Medical University, Harbin, China.
Chang-Xia
CX
Shao
Harbin Chest Hospital, Harbin, China.
Li-Na
LN
Zhao
Department of Microbiology; Wu Lien-Teh Institute, Harbin Medical University, Harbin, China.
Yuan-Ping
YP
Ma
Shen Zhen Protection and Treatment Center for Occupational Diseases, Shenzhen, China.
Liu-Zhuo
LZ
Zhang
Harbin Chest Hospital, Harbin, China.
Chun-Lei
CL
Zhang
Department of Microbiology; Wu Lien-Teh Institute, Harbin Medical University, Harbin, China.
Cai-Bo
CB
Dong
Division of Disaster-related Infectious Diseases, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan.
Toshio
T
Hattori
Department of Microbiology; Wu Lien-Teh Institute, Harbin Medical University, Harbin, China. lingh@ems.hrbmu.edu.cn.|Heilongjiang Provincial Key Laboratory of Infection and Immunity, Harbin, China. lingh@ems.hrbmu.edu.cn.|Department of Parasitology, Harbin Medical University; Key Laboratory of Pathogen Biology, Harbin, China. lingh@ems.hrbmu.edu.cn.
Hong
H
Ling
Multi-drug resistance; Mycobacterium tuberculosis; Primary resistance; Risk factors
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