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中国洛阳地区耐多药结核病的流行病学特征及危险因素。

Epidemiological characteristics and risk factors of multidrug-resistant tuberculosis in Luoyang, China.

机构信息

The First Affiliated Hospital and Clinical Medical College, Henan University of Science and Technology, Luoyang, China.

School of Medical Technology and Engineering, Henan University of Science and Technology, Luoyang, China.

出版信息

Front Public Health. 2023 May 9;11:1117101. doi: 10.3389/fpubh.2023.1117101. eCollection 2023.

Abstract

OBJECTIVE

We aimed to examine the prevalence of multidrug-resistant tuberculosis (MDR-TB) in Luoyang, China, identify related risk factors, inform clinical practices, and establish standardized anti-tubercular treatment regimens.

METHODS

We conducted a retrospective analysis of high-resolution melting curve (HRM) data from 17,773 cases (2,748 of which were positive) between June 2019 and May 2022 to assess the prevalence of MDR-TB and to identify its associated risk factors.

RESULTS

Between June 2019 and May 2022, out of the 17,773 HRM results, 2,748 were HRM-positive, and 312 were MDR-TB cases. The detection rates for HRM-positive and MDR-TB were 17.0 and 12.1% for males, and 12.4 and 8.2% for females, respectively. The MDR-TB detection rate was higher in the urban areas (14.6%) than in the rural areas (10.6%) and more common among individuals under 51 years of age (14.1%) than those over 50 years of age (9.3%). Notably, the rate of detecting MDR-TB was 18.3% higher in new male patients than in new female patients, which was at 10.6%, and this difference was statistically significant ( < 0.001). Moreover, the rate of MDR detection in females who had received anti-tuberculosis treatment (21.3%) was higher than that in males (16.9%). In the multivariate model that considered the results of the sputum smear and detection time, MDR-TB was positively correlated with a history of tuberculosis (TB) treatment, being male, being younger than 51 years, and living in urban areas.

CONCLUSION

Local TB infections are complex and diverse; therefore, more comprehensive monitoring methods are needed to curb the spread of MDR-TB.

摘要

目的

本研究旨在调查中国洛阳地区耐多药结核病(MDR-TB)的流行情况,确定相关危险因素,为临床实践提供信息,并制定标准化的抗结核治疗方案。

方法

我们对 2019 年 6 月至 2022 年 5 月期间 17773 例(其中 2748 例阳性)高分辨率熔解曲线(HRM)数据进行回顾性分析,以评估 MDR-TB 的流行情况,并确定其相关危险因素。

结果

2019 年 6 月至 2022 年 5 月,在 17773 例 HRM 结果中,2748 例 HRM 阳性,312 例为 MDR-TB 病例。男性的 HRM 阳性和 MDR-TB 检出率分别为 17.0%和 12.1%,女性分别为 12.4%和 8.2%。城区 MDR-TB 的检出率(14.6%)高于农村地区(10.6%),51 岁以下人群(14.1%)高于 50 岁以上人群(9.3%)。值得注意的是,新男性患者中 MDR-TB 的检出率(18.3%)高于新女性患者(10.6%),差异有统计学意义(<0.001)。此外,接受抗结核治疗的女性(21.3%)中 MDR 的检出率高于男性(16.9%)。在考虑痰涂片和检测时间结果的多变量模型中,MDR-TB 与结核(TB)治疗史、男性、年龄小于 51 岁以及居住在城区呈正相关。

结论

当地结核病感染情况复杂多样;因此,需要更全面的监测方法来遏制 MDR-TB 的传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/82b2/10203519/d1716607acd5/fpubh-11-1117101-g0001.jpg

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