High incidence of drug-resistant Mycobacterium tuberculosis in Hainan island, China.
Trop Med Int Health. 2019 Jul 06;:
Authors: Lin M, Zhong Y, Chen Z, Lin C, Pei H, Shu W, Pang Y
OBJECTIVES: To assess the proportion of drug-resistant tuberculosis (TB) cases, and to identify independent risk factors associated with drug-resistant TB in Hainan.
METHODS: Descriptive analysis of demographic and clinical data of culture-positive TB patients to assess the trends in drug-resistant TB at the Provincial Clinical Center on Tuberculosis of Hainan between 2014 and 2017.
RESULTS: 994 patients were recruited into the study. Overall, the proportion of patients resistant to at least one TB drug tested was 36.1% (359/994). The most frequent resistance was to isoniazid (INH, 29.8%), followed by rifampin (RIF, 29.3%), streptomycin (19.3%), ofloxacin (OFX, 17.4%), ethambutol (9.5%) and kanamycin (KAN, 3.2%). Of 291 RIF-resistant isolates, 228 (78.4%) were also resistant to INH, while the remaining 63 (21.6%) were susceptible to INH. Among those with multidrug-resistant tuberculosis (MDR-TB), 41.2% had additional resistance to OFX and and 3.9% to KAN. 8.8% of MDR-TB patients were affected by extensively drug-resistant (XDR-TB). Females were more likely to infected with MDR-TB than males, and young people (<20 years old) were more likely to have MDR-TB; patients exhibited decreasing MDR-TB risk with increasing age.
CONCLUSIONS: Our data provide the first primary understanding of the drug-resistant TB epidemic in Hainan. The high incidence of drug resistance, especially RIF- and FQ-resistance, highlight the importance of interventions for preventing epidemics of drug-resistant TB. Younger age is an independent predictor of MDR-TB, reflecting the potential transmission in this population. This article is protected by copyright. All rights reserved.
PMID: 31278806 [PubMed - as supplied by publisher]