Department of Tuberculosis, Chest Hospital of Xinjiang Uygur Autonomous Region, Urumqi, People's Republic of China.
PLoS One. 2012;7(2):e32103. doi: 10.1371/journal.pone.0032103. Epub 2012 Feb 22.
The multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) has emerged as a global threat. Xinjiang is a multi-ethnic region and suffered second highest incidence of TB in China. However, epidemiological information on MDR and XDR TB is scarcely investigated.
METHODOLOGY/PRINCIPAL FINDINGS: A prospective study was conducted to analyze the prevalence of MDR and XDR TB and the differences of drug resistance TB between Chinese Han and other nationalities population at Chest Hospital of Xinjiang Uygur Autonomous Region, China. We performed in vitro drug susceptibility testing of Mycobacterium tuberculosis to first- and second-line anti-tuberculosis drugs for all 1893 culture confirmed positive TB cases that were diagnosed between June 2009 and June 2011. Totally 1117 (59.0%, 95% CI, 56.8%-61.2%) clinical isolates were resistant to ≥1 first-line drugs; the prevalence of MDR TB was 13.2% (95% CI, 11.7%-14.7%), of which, 77 (30.8%; 95% CI, 25.0%-36.6%) and 31 (12.8%; 95% CI, 8.6%-17.0%) isolates were pre-XDR and XDR TB respectively. Among the MDR/XDR TB, Chinese Han patients were significantly less likely to be younger with an odds ratio 0.42 for age 20-29 years and 0.52 for age 40-49 years; P(trend) = 0.004), and Chinese Han patients has a lower prevalence of XDR TB (9.6%) than all the other nationality (14.9%).
CONCLUSIONS/SIGNIFICANCE: The burden of drug resistance TB cases is sizeable, which highlights an urgent need to reinforce the control, detection and treatment strategies for drug resistance TB. However, the difference of MDR and XDR TB between Chinese Han and other nationalities was not observed.
耐多药（MDR）和广泛耐药（XDR）结核病（TB）已成为全球威胁。新疆是一个多民族地区，是中国结核病发病率第二高的地区。然而，关于 MDR 和 XDR TB 的流行病学信息尚未得到充分调查。
方法/主要发现：本研究对新疆维吾尔自治区胸科医院收治的汉族和其他民族结核病患者的 MDR 和 XDR TB 患病率及耐药性差异进行了前瞻性研究。我们对 2009 年 6 月至 2011 年 6 月期间确诊的 1893 例培养阳性结核病患者的结核分枝杆菌进行了体外药物敏感性试验，检测了一线和二线抗结核药物。总共 1117 例（59.0%，95%置信区间，56.8%-61.2%）临床分离株对至少一种一线药物耐药；MDR TB 的患病率为 13.2%（95%置信区间，11.7%-14.7%），其中预 XDR 和 XDR TB 分别为 77 例（30.8%，95%置信区间，25.0%-36.6%）和 31 例（12.8%，95%置信区间，8.6%-17.0%）。在 MDR/XDR TB 中，汉族患者年龄<20 岁和 40-49 岁的可能性显著降低，比值比（OR）分别为 0.42 和 0.52；P（趋势）=0.004），汉族患者 XDR TB 的患病率（9.6%）低于其他所有民族（14.9%）。
结论/意义：耐药结核病病例负担较大，迫切需要加强耐药结核病的控制、检测和治疗策略。然而，汉族和其他民族之间的 MDR 和 XDR TB 差异并未观察到。
