Drug resistance characteristics of 1 277 isolates of Mycobacterium tuberculosis in Henan province in 2021
Objective To understand the drug resistance characteristics of Mycobacterium tuberculosis in Henan province,and provide data support for the clinical treatment and prevention of tuberculosis.Methods Mycobacterium tuberculosis(M.tuberculosis)isolates from newly diagnosed smear-positive pulmonary tuberculosis patients in 30 counties(cities and districts)of Henan province in 2021 were collected.Drug susceptibility tests on 9 anti-tuberculosis drug[Isoniazid(INH),Rifampicin(RFP),Streptomycin(SM),Ethambutol(EMB),Ofloxacin(OFX),Kanamycin(KM),Moxifloxacin(MFX),Levofloxacin(LFX),Amikacin(AM)]were conducted using the proportion method based on the solid medium,and the drug resistance was analyzed.Results A total of 1 277 isolates of M.tuberculosis were collected,with an overall drug resistance rate of 23.88％(305/1 277),single drug resistance rate of 11.35％(145/1 277),multi-drug resistance rate of 5.17％(66/1 277),poly-drug resistance rate of 7.36％(94/1 277),pre-extensive resistance rate of 0.47％(6/1 277)and extensive resistance rate of 0.31％(4/1 277).The highest resistant rate of M.tuberculosis to first-line drugs was SM(14.72％,188/1 277),followed by INH(12.53％,160/1 277);the highest resistant rate of M.tuberculosis to second-line drugs was OFX(5.4％,69/1 277),followed by LFX(4.23％,54/1 277).M.tuberculosis isolates from initially-treated tuberculosis patients had lower resistant rate to the nine drugs tested than those from retreated patients(all P＜0.05).Of the 66 multidrug-resistant isolates,the top three patterns with the highest proportions were RFP+INH+SM(12.12％,8/66),RFP+INH+EMB+SM(27.27％,18/66)and RFP+INH+EMB+SM+OFX+LFX+MFX(21.21％,14/66).There was single-directional cross-resistance between SM and AM(KM),and bidirectional cross-resistance at low concentration between AM and KM,and mutual cross-resistance between MFX,LFX and OFX.Conclusions The overall drug resistance,multidrug resistance and quinolone drug resistance of Mycobacterium tuberculosis in Henan province are still relatively serious,and active measures should be taken to reduce the drug resistance rate and the spread of drug-resistant tuberculosis.
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