Abstract:

Objective To analyze the drug resistance of Mycobacterium tuberculosis in Jining area for scientific evidences to develop rational medication regimen in clinic for tuberculosis. Methods Sputum and lavage fluid as well as other samples were harvested from TB patients in Jining Public Health Medical Center from 2018 to 2023. All samples were cultured, and phenotypic drug sensitivity test was conducted on the isolates with positive results of Mycobacterium tuberculosis complex. The drug resistance against rifampin (RFP), isoniazid (INH), ethambutol (EMB), streptomycin (Sm), amikacin (Am), kanamycin (Km), and levofloxacin (LFX), together with the demographic characteristics of drug-resistant patients, was analyzed. Results In total, 3 348 isolates of Mycobacterium tuberculosis were obtained, with a total drug resistance rate of 23.33% (781/3 348). The single drug resistance rate, rate of multidrug resistance, poly resistance rate, pre extensive drug resistance rate and extensive drug resistance rate were 13.02% (436/3 348), 6.69% (224/3 348), 3.61% (121/3 348), 1.31% (44/3 348), and 0.53% (18/3 348), respectively. The drug-resistance was most seen in males (72.60%, 567/781), farmers (76.70%, 599/781), and patients aged between 20 and 39 years (35.21%, 275/781). There was no significant change in the overall drug resistance rate, single drug resistance rate, rate of multi-drug resistance, poly resistance rate and extensive multi drug resistance rate of Mycobacterium tuberculosis isolates from 2018 to 2023 (all P>0.05). The resistance rate prior to occurrence of extensive drug resistance showed a fluctuating upward trend (P<0.05). The top three single drug resistance rates were Sm (18.91%, 633/3 348), INH (13.59%, 455/3 348) and LFX (10.27%, 344/3 348). In terms of the composition of drug resistance spectrum, single drug resistance was dominated by INH (13.19%, 103/781) and Sm (38.03%, 297/781), and the combination of INH+Sm showed the highest multidrug resistance (25.10%, 196/781). Combined multidrug resistance was dominated respectively by RFP+INH+Sm (6.66%, 52/781) and RFP+INH+EMB+Sm (6.91%, 54/781). Extensive drug resistance occurred most in the early stage was associated with combination of RFP+INH+EMB+Sm+LFX (2.18%, 17/781) and RFP+INH+EMB+Sm+LFX+Km+Am (0.90%, 7/781). Conclusion The drug resistance rate of Mycobacterium tuberculosis in Jining area still remains at a higher level, and there is no room for optimism in prevention and control of drug resistance in this area, for which standardized use of anti-tuberculosis drugs in clinic should be further strengthened in order to reduce the incidence of drug resistance.

Key words: Mycobacterium tuberculosis, Anti-tuberculosis drugs, Drug resistance, Jining City