Epidemiological analysis of drug-resistant tuberculosis in Shanxi from 2016 to 2020

  Objective   This study aimed to understand the epidemic status of drug-resistant tuberculosis (DR-TB) in Shanxi Province in recent 5 years, and to provide scientific basis for the formulation of DR-TB prevention and control policies in Shanxi province.

  Methods   The drug-resistance screening, drug-resistance detection and comprehensive diagnosis results of patients with positive etiological tuberculosis registered from 2016 to 2020 were collected from tuberculosis Information Management System, a sub-system of China Disease Control and Prevention Information System, and to conduct a descriptive analysis of the prevalence of DR-TB in Shanxi Province.

  Results  A total of 16214 patients with etiologically positive pulmonary tuberculosis were registered in Shanxi province from 2016 to 2020, and 8075 strains of Mycobacterium tuberculosis were cultured positive. The total drug resistance rate, multi-drug resistance rate, single drug resistance rate, poly-resistance rate, and extensively drug-resistance rate of 8075 strains were 11.49%(928/8075), 8.54%(690/8075), 1.93%(156/8075), 0.80%(65/8075) and 0.21%(17/8075), respectively. In recent 5 years, the total drug resistance rate and multi-drug resistance rate and extensively drug-resistance rate showed a downward trend (trends χ²=276.329, P<0.001; trends χ²=297.186, P<0.001; trends χ²=6.300, P<0.05). The total drug resistance rate 23.89% (308/1289) and the multi-drug resistance rate 18.23% (235/1289) of the retreated patients were significantly higher than those of the untreated patients the total drug resistance rate was 9.14% (620/6786), and the multi-drug resistance rate was 6.7% (455/6786), and the difference was statistically significant (χ²=231.95, P<0.001; χ²=184.155, P<0.001).In recent 5 years, the number of drug-resistant tuberculosis patients has been increasing year by year, the main groups are initial treated patients, young and middle-aged people and farmers. the spectrum of drug resistant tuberculosis became more complicated, and the single drug resistant strains were mainly rifampicin-resistant bacteria, while the multi-drug resistant strains were mainly H+R and H+R+S, and 16 strains were H+R+S+E+OF in initial treated patients.

  Conclusion   The prevention and control situation of drug-resistant tuberculosis in Shanxi Province is still severe. The awareness of tuberculosis prevention and control dearing young and middle-aged people and farmers should be strengthen, standardize clinical drug use, and strengthen the health management of tuberculosis patients to avoid or reduce the occurrence of drug-resistant tuberculosis.