Drug Resistance Analysis Of 1250 Pulmonary Tuberculosis Cases

Objective: Our study was aim to understand the drug resistance of smear-positive TB patients, provide a scientific basis for clinical treatment and medication, and a reference for future prevention and treatment of tuberculosis through retrospective study.Methods: One thousand two hundred and fifty study subjects were recruited from Changchun City Hospital for Infectious Diseases between May 2012 and June 2014. Ziehl- Nigeria staining microscopy was used to conduct sputum smear. Roche traditional culture was used to isolated culture. WHO recommended proportion method susceptibility testing was used to conduct strains resistant test. Related information of patients with drug resistance was collected. The data was processed and analyzed by using Excel and SPSS16.0 statistical software.Results: ① There were 917 male and 333 female in the a total of 1250 study subjects. The youngest patient was 15 years old and the oldest was 93 years old. The average age of all patients was 49 ± 14 years old. 701 cases were in 40~60 years old who accounted for 56.1%. 521 newly diagnosed patients accounted for 41.7% of all study subjects. 729 retreatment patients accounted for 58.3%; most patients were farmers who accounted for 60.5%; Han patients were the most who accounted for 98.3%. ② The drug-resistant rates from 2012 to 2014 were respectively 62.25%, 60.47%, and 59.79%. ③ The overall drug-resistance rate was 60.96%. Drugresistance rate for newly diagnosed patients was 41.07%. Drug-resistant retreatment rate in retreatment patients was 75.17%. Drug-resistance rates of antituberculosis drugs were respectively 47.44%(rifampin), 40.40%(isoniazid), 33.84%(ofloxacin), kanamycin was 6.8%. ④Among 1250 patients monoresistance rate was 19.76%; multidrug resistance(MDR) rate was 30.48%; polyresistance rate was 6.80%; extensively drug resistance(XDR) rate was 3.92%. MDR rate and XDR rate of newly diagnosed patients were respectively 4.39% and 1.15%. MDR rate and XDR rate of retreatment patients were respectively 41.98% and 5.90%. ⑤ Isoniazid + rifampicin + ofloxacin resistance was the most common drug-resistance type in MDR patients. 211 cases of this drug-resistance type accounted for 55.38% of MDR patients. ⑥ There were significant differences in the proportion of the four drug types among patients with different ages(P <0.001). Monoresistance accounted for the highest proportion in the patients over 60 years old which accounted for 50.00%. Multidrug resistance accounted for the highest proportion in the patients with 15 ~ 20 years old, 20~40 years old and 40 ~ 60 years old. The ratios were respectively 63.63%, 61.93% and 50.44%. There were significant differences in drug resistance among patients with different ages(P <0.001); Drug-resistance rate of isoniazid and rifampicin were both the highest in patients with 20~40 years old and the rates were respectively 46.06% and 51.07%. ⑦ There were significant differences in the proportion of the four drug types between newly diagnosed patients and retreatment patients(P <0.001). Monoresistance accounted for the highest proportion in the newly diagnosed patients and the ratio was 54.67%. MDR accounted for the highest proportion in the retreatment patients and the ratio was 55.84%. The rates of four drugs in retreatment patients were all higher than the rates in newly diagnosed patients(P <0.001).Conclusion: ① Drug-resistance rates in descending order were rifampin, isoniazid, ofloxacin, and kanamycin. ② Loxacin resistance situation was serious in MDR patients.③ There were significant differences in the proportion of the four drug types among patients with different ages. Monoresistance accounted for the highest proportion in the patients over 60 years old. Multidrug resistance accounted for the highest proportion in the patients younger than 60 years old. ④ MDR accounted for the highest proportion in the retreatment patients. The rates of four drugs in retreatment patients were all higher than the rates in newly diagnosed patients.