Abstract:

Objective To analyze the pyrazinamide (PZA) resistance in multidrug-resistant Mycobacterium tuberculosis (MDR-TB) clinical isolates in Fujian province.Methods A total of 119 MDR-TB clinical isolates and the basic information of MDR-TB patients were collected during the antituberculosis drug resistance surveillance in Fujian Center for Disease Control and Prevention from 2008 to 2010. The average age of the patients was (45.8±15.3) years, of which 76.5% (91/119) were male, 30.3% (36/119) were floating population, 55.5% (66/119) were peasants, and 53.8% (64/119) were patients with primary school education or below. Using the standard strain H37Rv as the control, the BACTEC ^TM MGIT 960 ^TM system (MGIT 960) and the proportional method recommended by the WHO were used to perform the drug susceptibility test of PZA and other antituberculosis drugs on strains in the L-J solid medium. The descriptive analysis of data was performed by SPSS 17.0, and the Chi square test was used on enumeration data. P<0.05 was considered statistically significant. Results Of these 119 MDR-TB clinical isolates, 44 were detected resistant to PZA (37.0%). Among the MDR-TB patients with different demographic characteristics, the PZA resistance rate of patients with primary school education or below (26.6%, 17/64) was lower than those with above primary school education (49.1%, 27/55) (χ ²=6.44, P=0.011). The PZA resistance rates in patients with ethambutol, streptomycin, ofloxacin, levofloxacin and moxifloxacin resistance was 48.6% (36/74), 44.9% (31/69), 62.5% (20/32), 63.3% (19/30), and 71.4% (10/14), respectively; which was significantly higher than that of sensitive patients (17.8% (8/45), 26.0% (13/50), 27.6% (24/87), 28.1% (25/89), and 32.4% (34/105))(χ ²=11.44, P=0.001; χ ²=4.46, P=0.035; χ ²=12.24, P<0.001; χ ²=11.96, P=0.001; χ ²=8.08, P=0.004). Conclusion We should pay more attention to the PZA susceptibility test to provide timely and effective treatment to the patients in the prevention and treatment of multidrug-resistant tuberculosis in Fujian province.

Key words: Mycobacterium tuberculosis, Tuberculosis, multidrug-resistant, Pyrazinamide, Data interpretation, statistical, Fujian province