Epidemiological trend of drug-resistant Mycobacterium tuberculosis in Songjiang District of Shanghai from 2014 to 2018 / 中国基层医药

ABSTRACT

Objective:To analyze the prevalence of drug-resistant Mycobacterium tuberculosis in Songjiang District, Shanghai.Methods:A retrospective analysis of 1 105 strains of Mycobacterium tuberculosis, which was positive in culture from January 2014 to December 2018 in Songjiang District, Shanghai, was carried out for strain identification (PNB method, TCH method and 28℃ culture test) and drug susceptibility test (four first-line anti-tuberculosis drugs).Results:The total drug resistance rate was 18.8% (208/1 105), of which the resistance rate of newly diagnosed patients was 17.9%(189/1 058), and the resistance rate of retreated patients was 40.4% (19/47). The total multidrug resistance rate was 4.0% (44/1 105), of which the multidrug-resistant rate of newly diagnosed patients was 3.4% (36/1 058), and the multidrug resistance rate of retreated patients was 17.0% (8/47). The five-year total drug resistance rate, the drug resistance rate of newly diagnosed patients, the drug resistance rate of retreatment patients, the total multidrug resistance rate, the multidrug resistance rate of newly diagnosed patients, and the multidrug resistance rate of retreated patients had no upward trend (χ 2 trend values: 4.229, 3.871, 6.862, 2.764, 4.930, 1.955, all P>0.05). In the past five years, the multi-drug resistance rates were 2.6%, 3.5%, 4.4%, 4.5%, and 5.4%, respectively, increased year by year.Logistic regression analysis showed that males, elderly people, retreated patients and floating population were the main factors of tuberculosis in our district, and patients with retreatment were more likely to develop drug resistance ( OR=0.321, 95% CI: 0.175-0.586, P<0.01) and multidrug-resistant ( OR=0.172, 95% CI: 0.075-0.394, P<0.01). Conclusion:In the past five years, the prevalence of M. tuberculosis in Songjiang District of Shanghai has been relatively stable, and the rate of multidrug resistance has increased year by year.