Abstract:

Objective To analyze the drug resisitant of Mycobacterium tuberculosis (MTB) isolates in Longyan from 2015 to 2017, and provide the scientific evidence for TB control and prevention.Methods A total of 837 consecutive cases of smear positive pulmonary tuberculosis. Registered in Longyan Center for Disease Control and Prevention were collected from June 1, 2015 to December 31, 2017,including 698 new cases and 139 retreatment cases. Another 289 new cases of smear negative pulmonary tuberculosis (including newly treated patients) were collected in 2017, according to the new TB control model of tiered medical and comprehensive control service. Then the sputum samples from the 1126 TB patients were collected for culture. Of the 671 sputums (59.6%) were cultured positive, and the strains from cultures were identified and tested for drug susceptibility. Finally analyzing the data by Chi square test,trend chi square test and Fisher exact test in software SPSS 18.0, and the boundary of test was defined as 0.05.Results A total of 651 strains (97.0%) were identified as Mycobacterium tuberculosis complex and 20 were non-tuberculous mycobacteria. The culture positive rate of new and retreatment cases showed an increasing trend year by year, from 24.5% (137/559) to 86.5% (301/348) and from 27.2% (25/92) to 90.3% (56/62), respectively( {\chi }_{\mathrm{trend}}^2 =360.41,71.23;Ps=0.000). The results of drug sensitivity tests to the 9 antituberculosis drugs show that the total resistance rate was 22.0% (143/651), and the rate of multidrug resistance was 6.5% (42/651). The difference of mono-drug resistance rate between the new cases (12.2%,72/592) and retreatment cases(8.5%,5/59) was nonsignificance. The rate of total resistance (20.3%,120/592), poly-drug resistance (3.0%,18/592) and multi-drug resistance (5.1%,30/592) in new cases were significantly lower than those of retreatment cases (39.0% (23/59), 10.2% (6/59), 20.3% (12/59))(χ ²=10.96,P=0.001;χ ²=7.68,P=0.006;χ ²=20.73,P=0.000). The drugs with higher resistance rate are respectively S (3.7%,24/651), Ofx (3.1%,20/651), H (2.2%(14/651)), R (1.4%,9/651) and Cm (1.1%,7/651). Conclusion The drug resistance profile was diverse among each county in Longyan, and also different from the whole country and Fujian province. Therefore, the implementation of drug resistant test should be reinforced and improved in Longyan.

Key words: Mycobacterium tuberculosis, Tuberculosis, multidrug-resistant, Microbial sensitivity tests, Data interpretation, statistical, Longyan city