Analysis of drug resistance characteristics in elderly tuberculosis of Guangdong province from 2014-2020

doi:10.19871/j.cnki.xfcrbzz.2023.05.002

Abstract

Abstract: Objective To investigate the drug resistance of tuberculosis (TB) strains isolated from elderly patients (aged≥60 years) in Guangdong Province from 2014 to 2020 and to evaluate the characteristics of drug resistance of Mycobacterium tuberculosis (MTB) from different sources. Method MTB strains in elderly patients were collected from 32 sentinel sites of TB resistance surveillance in Guangdong province from January, 2014 to December, 2020.Drug sensitivity tests for first - and second-line of anti-tuberculosis drugs [including isoniazid (INH), ethambutol (EMB), rifampicin (RFP), streptomycin (Sm) and kanamycin (Km), capreomycin (Cm), protionamide (Pto), ofloxacin (Ofx), sodium p-aminosalicylate (PAS)] were conducted according to a proportional method. The data of drug resistance of TB was analyzed. Result A total of 9590 MTB isolates were collected during 2014-2020, accounting for 24.6% of the total detection rate of MTB (9590/39046). There was significant difference in the detection rate of MTB during study period (P_trend<0.001).The drug resistance rate, monoresistance rate, polyresistance rate, multidrug resistance rate (MDR) and extensively drug resistance rate (XDR) of MTB was 26.7%, 13.0%, 5.0%, 5.0%, and 2.1%, respectively. There was significant difference in the the distribution of monoresistance rate, MDR rate and XDR rate of MTB during study period (P<0.05). The rates of MDR and XDR in female patients were significantly higher than those in male patients (P<0.05), the rates of polyresistance rate, MDR and XDR in elderly patients living in the Pearl River Delta region were significantly higher than those living in eastern and northwestern Guangdong province (P<0.05). The resistance rate of the isolates to any one of the first- and second-line anti-tuberculosis drugs from high to low was Sm(14.9%)>INH(11.6%)>EMB(7.5%)>RFP(7.1%)>Ofx(5.8%)>PAS(5.0%)>Pto(4.6%)>Cm(4.0%)>Km(3.7%). Except for EMB and Pto, the distribution of those 9 drug resistance rate of MTB during study period was significance (P_trend<0.05). The XDR of MTB in retreated patients was significantly higher than that in initially treated patients (P=0.006). Conclusion The drug resistance rate of TB in elder patients is high. The MTB resistance in patients whom living in Pearl River Delta, whom were female and whom were retreated patients should be paid special attention by clinical workers.

Key words: Mycobacterium tuberculosis, Surveillance, Elderly patients, Drug resistance

CLC Number:

R521

Zhuo Wenji, Zhang Chenchen, Chen Xunxun, Chen Yanmei, Yu Meiling, Wei Wenjing, Xu Liaoyue, Peng Kehao, Lai Xiaoyu. Analysis of drug resistance characteristics in elderly tuberculosis of Guangdong province from 2014-2020[J]. Electronic Journal of Emerging Infectious Diseases, 2023, 8(5): 6-10.

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