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Open Access Research article

Rates and risk factors for drug resistance tuberculosis in Northeastern China

Qiao Liu1, Limei Zhu1, Yan Shao1, Honghuan Song1, Guoli Li1, Yang Zhou1, Jinyan Shi2, Chongqiao Zhong2, Cheng Chen1* and Wei Lu1*

Author Affiliations

1 Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, 172 Jiangsu Rd, Nanjing 210009, PR China

2 Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Lianyungang City, Lianyungang, PR China

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BMC Public Health 2013, 13:1171  doi:10.1186/1471-2458-13-1171

Published: 13 December 2013

Abstract

Background

Drug-resistant tuberculosis (TB) has emerged as a major challenge toward TB control and prevention. In Lianyungang city, the extent and trend of drug resistant TB is not well known. The objective of the survey was to assess drug resistance pattern of MTB and risk factors for drug resistant TB, including multidrug resistance tuberculosis (MDR-TB) in this area.

Methods

We performed drug susceptibility testing on Mycobacterium tuberculosis (MTB) isolates with first- and second-line anti-tuberculosis drugs of 1012 culture positive TB cases by using the proportion method, who were consecutively enrolled from January 2011 to December 2012 in Lianyungang city, China. The patterns of drug resistance in MTB were investigated and multiple logistic regression analysis was performed to assess the risk factors for drug resistant TB.

Results

Among the 1012 strains tested, 308 (30.4%) strains were resistant to at least one first-line drug; the prevalence of MDR-TB was 88 (8.7%), 5 (0.5%) strains were found to be extensively drug-resistant tuberculosis (XDR-TB). Female gender was a risk factor for MDR-TB (adjusted odds ratio (aOR) 1.763, 95% CI (1.060-2.934). The aged 28–54 years was significantly associated with the risk of MDR-TB with an aOR: 2.224, 95% CI (1.158-4.273) when compared with those 65 years or older. Patients with previous treatment history had a more than 7-fold increased risk of MDR-TB, compared with those never previously treated.

Conclusions

The burden of drug resistant TB cases is sizeable, which highlights an urgent need to reinforce control, detection and treatment strategies for drug resistant TB.

Keywords:
Epidemiology; MDR-TB; Drug resistance; Drug susceptibility