Adhikari Lila, Wangchuk Sonam, Bhujel Pavitra, Zangmo Sherab, Lhaden Pema, Dorji Ugyen, Tshering Karchung
Royal Centre for Disease Control, Ministry of Health, Bhutan.
IJID Reg. 2022 Apr 29;3:228-233. doi: 10.1016/j.ijregi.2022.04.012. eCollection 2022 Jun.
Bhutan is no exception to the rising global threat of drug resistance tuberculosis (TB), particularly multidrug-resistant (MDR) TB. Although drug resistance surveillance has been carried out in Bhutan since 2010, limited analysis reports are available. Therefore, we looked at data from 2015-2019 to understand patient characteristics.
To obtain data for MDR-TB from the past 5 years, we looked at manual registers and laboratory worksheets for all samples received at National TB Reference Laboratory. Epidemiological factors and laboratory variables were analyzed using descriptive statistics.
Among 304 patients with MDR-TB, 85.20% (n=259) are new cases with no previous history of treatment. Those aged 16-25 years from both genders are affected more (46.05%, n=140) than other age groups. The majority (94.62%, n=264) of rifampicin resistance was found in the gene. For Isoniazid, 97.13% (n=271) resistance was seen in the of the gene.
A high number of MDR-TB cases among new patients and little variation in the resistance band pattern over 5 years could indicate uncontrolled ongoing transmission. Whole-genome sequencing for the samples is required to further understand the epidemiology of the resistance pattern.
不丹也未能幸免于全球耐药结核病（TB），尤其是耐多药（MDR）结核病日益增长的威胁。尽管自2010年以来不丹一直在开展耐药监测，但可用的分析报告有限。因此，我们查看了2015 - 2019年的数据以了解患者特征。
为获取过去5年耐多药结核病的数据，我们查看了国家结核病参考实验室收到的所有样本的手工登记册和实验室工作表。使用描述性统计分析流行病学因素和实验室变量。
在304例耐多药结核病患者中，85.20%（n = 259）为新发病例，既往无治疗史。16 - 25岁的男女患者受影响的比例（46.05%，n = 140）高于其他年龄组。大部分（94.62%，n = 264）利福平耐药在 基因中被发现。对于异烟肼，97.13%（n = 271）的耐药在 基因的 中被观察到。
新患者中耐多药结核病病例数量众多，且5年间耐药谱模式变化不大，这可能表明传播仍未得到控制。需要对样本进行全基因组测序以进一步了解耐药模式的流行病学情况。
