Du Liang, Zhang Yu, Lv Xintong, Duan Yuxin, Shi Xiaoyan, Ji Haoqiang, Wu Ruiheng, Xu Jia, Chen Xu, Gao Yang, Lu Xiwei, Zhou Ling
School of Public Health, Dalian Medical University, Dalian, Liaoning, 116044, People's Republic of China.
Dalian Tuberculosis Hospital, Dalian, Liaoning, 116031, People's Republic of China.
Infect Drug Resist. 2021 Mar 16;14:1037-1047. doi: 10.2147/IDR.S294611. eCollection 2021.
Multidrug-resistant tuberculosis (MDR-TB) is the cause of serious health and economic burdens worldwide. The present study aimed to explore the initial and acquired drug-resistance rates among TB patients from 2012 to 2019 in Dalian, China. The effectiveness of MDR-TB prevention and control strategies were then evaluated.
Drug susceptibility testing (DST) was performed for 6429 diagnosed, culture-positive, (MTB) strains, including 4661 new cases and 1768 previously treated cases. Descriptive statistics were employed to calculate the frequencies and percentages of TB strains, and the average annual growth rates (AAGRs) for each strain were calculated. The Chi-square test was applied to examine the significance of linear drug-resistance trends over time during the study period.
Over the eight-year study period, the percentages of both initial (from 9.01% to 4.82%) and acquired (from 40.85% to 9.09%) MDR-TB cases decreased significantly, AAGRs of 8.55% and 19.32%, respectively. Among new and previously treated TB patients, significant downtrends were observed for the rates of both initial and acquired MDR-TB among young and middle-aged individuals ( < 0.05). Additionally, among both new and previously treated TB patients, the percentages of individuals with drug resistance against isoniazid (INH), rifampicin (RFP), ofloxacin (OFX), and amikacin (AMK) decreased significantly ( < 0.05) from 2012 to 2019 in Dalian, China.
The initial and acquired multidrug resistance rates exhibited significantly decreasing trends from 2012 to 2019, suggesting that MDR-TB prevalence has been controlled effectively in Dalian, China. The MDR-TB epidemic was reversed in the short term by establishing feasible strategies for detection, diagnosis, treatment, and infection control.
耐多药结核病（MDR-TB）是全球严重健康和经济负担的根源。本研究旨在探讨2012年至2019年中国大连结核病患者的初始耐药率和获得性耐药率。然后评估耐多药结核病防控策略的有效性。
对6429株确诊的、培养阳性的结核分枝杆菌（MTB）菌株进行了药敏试验（DST），其中包括4661例新发病例和1768例既往治疗病例。采用描述性统计方法计算结核菌株的频率和百分比，并计算各菌株的年均增长率（AAGRs）。应用卡方检验来检验研究期间耐药线性趋势随时间变化的显著性。
在为期八年的研究期间，初始耐多药结核病（从9.01%降至4.82%）和获得性耐多药结核病（从40.85%降至9.09%）的百分比均显著下降，年均增长率分别为8.55%和19.32%。在新发病例和既往治疗的结核病患者中，青年和中年个体的初始和获得性耐多药结核病发病率均呈现显著下降趋势（P<0.05）。此外，在新发病例和既往治疗的结核病患者中，2012年至2019年期间，中国大连对异烟肼（INH）、利福平（RFP）、氧氟沙星（OFX）和阿米卡星（AMK）耐药的个体百分比均显著下降（P<0.05）。
2012年至2019年期间，初始和获得性耐多药率呈现显著下降趋势，表明中国大连的耐多药结核病流行已得到有效控制。通过建立可行的检测、诊断、治疗和感染控制策略，耐多药结核病疫情在短期内得到了扭转。
