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《Chinese Journal of Antituberculosis》 2020-03
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Analysis of drug resistance in patients with smear-negative and culture-positive pulmonary tuberculosis in Guangdong province in 2016

CHEN Yan-mei;HUANG Xin-chun;SUN Qi;ZHANG Chen-chen;WEN Wen-pei;CHEN Liang;Center for Tuberculosis Control of Guangdong Province;  
Objective This study aimed to investigate the drug resistance status of patients with smearnegative while culture-positive pulmonary tuberculosis(PTB) in Guangdong province.Methods A total of 12 323 newly diagnosed smear-negative PTB patients from 32 tuberculosis drug resistance surveillance sites in Guangdong province during January-December 2016 were collected as research subjects.After sputum culture,1224 were culture positive,with culture positive rate of smear-negative of 9.9%.The results of strain identification tests indicated that 1177 cases(96.16%) were Mycobacterium tuberculosis complex,and 47 cases(3.84%) were nontuberculous mycobacteria(NTM).Then,drug sensitivity tests were performed on 1177 strains identified as Mycobacterium tuberculosis complex with 9 different anti-TB drugs,which were isoniazid(INH),streptomycin(Sm),rifampicin(RFP),ethambutol(EMB),kanamycin(Km),ofloxacin(Ofx),capriomycin(Cm),propionamide(Pto) and p-aminosalicylic acid(PAS).Results Totally,12 323 sputum isolates from newly diagnosed patients with smear-negative PTB were cultured,and the results showed that the total resistance rate was 29.57%(348/1177),including a multidrug resistance(MDR) rate of 2.38%(28/1177),extensive drug resistance(XDR)rate of 0.08%(1/1177),single drug resistance rate of 17.42%(205/1177),and a polyresistance rate of 9.77%(115/1177).We also found that the MDR rate(2.94%,25/849) in men were significantly higher than those in women(0.91%,3/328),with significant statistical differences(χ~2=4.19,P=0.040).There were 52 types of MDR spectrum,among which,INH+Sm resistant types were the most,accounting for 20.87%(24/1150,followed by Sm+Km resistant types,accounting for 9.57%(11/115).Conclusion Patients with smear-negative and culture-positive PTB in Guangdong province have a higher drug resistance rate.Monitoring and management should be strengthened to reduce the occurrence of drug-resistant tuberculosis.
【Fund】: “十三五”国家科技重大专项(2018ZX10715004-002、2018ZX10722301-004-004)
【CateGory Index】: R446.5;R521
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