Objective To analyze the molecular epidemiological characteristics and drug resistance profiles of Mycobacterium tuberculosis isolates from drug resistance surveillance areas in Jiangxi province, provide evidence for the development of targeted tuberculosis prevention and control strategies.

Methods  A total of 691 M. tuberculosis isolates from three national drug-resistant surveillance areas during 2020−2023 were collected. Genotyping was conducted by using Mycobacterium interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) to determine the clustering rate and recent transmission dynamics, and the relationship between genotype and clustering as well as drug resistance.

Results The 691 isolates were classified into 658 unique genotypes and 14 gene clusters by VNTR9+3. The overall clustering rate was 4.78%, with a minimum estimated recent infection rate of 2.75%. Group I was the predominant genotype group in the three drug resistance surveillance areas in Jiangxi, accounting for 78.15%. Beijing genotype showed significant associations with resistance to rifampicin, streptomycin, and ofloxacin.

Conclusion The tuberculosis patients identified in the three drug resistance surveillance areas in Jiangxi were mainly ones due to endogenous reactivation. It is important for prevention and control institutions to enhance the standardized treatment protocols for these patients, conduct comprehensive screening for latent infections for the effective preventive treatment, and improve screening strategy for active infection source finding to facilitate early detection and timely treatment, thereby effectively interrupting the transmission at its source.