Han Ning, Yan Libo, Yuan Man, Chen Zhu, Zeng Yilan, Tang Hong
Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Laboratory of Infectious and Liver Diseases, Institution of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Trop Med Int Health. 2025 Jul;30(7):704-711. doi: 10.1111/tmi.14126. Epub 2025 May 15.
This study aimed to determine the epidemiological characteristics of drug-resistant tuberculosis (DR-TB) and investigate the risk factors associated with multidrug-resistant tuberculosis (MDR-TB) in Sichuan, China.
The study involved 5180 clinical isolates collected from Sichuan since 2013, with non-tuberculous mycobacteria excluded. Drug susceptibility testing was conducted using four first-line anti-TB drugs, fluoroquinolones, and second-line injectable agents. Multivariable logistic regression analysis was used to assess risk factors for MDR-TB based on patients' treatment history, age, sex, ethnicity, health facility, living environment and human immunodeficiency virus (HIV) status.
Among the 5180 participants, resistance was highest for isoniazid (23.59%), followed by rifampin (18.42%), streptomycin (18.42%) and ethambutol (2.47%). The prevalence of MDR-TB was 774 (14.94%) among all cases, with 575 (14.20%) in newly diagnosed tuberculosis (TB) patients and 199 (17.60%) in previously treated patients. Additionally, 17 (0.33%) patients were diagnosed with MDR-TB. Furthermore, urban living was identified as a protective factor against MDR-TB (odds ratio [OR] 0.80, 95% confidence interval [CI] 0.68-0.94, p = 0.004). Notably, individuals younger than 60 were more likely to develop MDR-TB, especially those aged 32-45 (OR 2.22, 95% CI 1.74-2.83, p < 0.001). In addition, HIV-positive status was identified as a risk factor for MDR-TB (OR 2.06, 95% CI 1.21-3.49, p = 0.008).
The study demonstrated that the prevalence of DR-TB among the study subjects exceeded the national level. Patients living in rural areas, those with a history of TB treatment, HIV-positive individuals, and younger patients were more likely to develop MDR-TB.
本研究旨在确定中国四川省耐多药结核病（DR-TB）的流行病学特征，并调查与耐多药结核病（MDR-TB）相关的危险因素。
该研究纳入了自2013年以来从四川收集的5180株临床分离株，排除了非结核分枝杆菌。使用四种一线抗结核药物、氟喹诺酮类药物和二线注射剂进行药敏试验。基于患者的治疗史、年龄、性别、种族、医疗机构、生活环境和人类免疫缺陷病毒（HIV）感染状况，采用多变量逻辑回归分析评估耐多药结核病的危险因素。
在5180名参与者中，异烟肼耐药率最高（23.59%），其次是利福平（18.42%）、链霉素（18.42%）和乙胺丁醇（2.47%）。所有病例中耐多药结核病的患病率为774例（14.94%），新诊断结核病（TB）患者中为575例（14.20%），既往治疗患者中为199例（17.60%）。此外，17例（0.33%）患者被诊断为耐多药结核病。此外，城市居住被确定为耐多药结核病的一个保护因素（比值比[OR] 0.80，95%置信区间[CI] 0.68 - 0.94，p = 0.004）。值得注意的是，60岁以下的个体更易发生耐多药结核病，尤其是32 - 45岁的人群（OR 2.22，95% CI 1.74 - 2.83，p < 0.001）。此外，HIV阳性被确定为耐多药结核病的一个危险因素（OR 2.06，95% CI 1.21 - 3.49，p = 0.008）。
该研究表明，研究对象中耐多药结核病的患病率超过了国家水平。居住在农村地区的患者、有结核病治疗史的患者、HIV阳性个体以及年轻患者更易发生耐多药结核病。
