Authors
Cifu Xie, Pengliang Yin, Lixin Song, Zi Xiong
Published in
Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences. Volume 51. Issue 5. Pages 967-976. May 28, 2026.
Abstract
Drug-resistant tuberculosis is one of the major challenges currently faced in tuberculosis prevention and control. Regional studies on drug resistance profiles and their influencing factors are of great significance for understanding epidemiological patterns and developing precise prevention and control strategies. This study aims to analyze the drug resistance characteristics and trends of pulmonary tuberculosis in Changsha from 2018 to 2025, and to explore the factors associated with rifampicin (RFP) resistance, so as to provide scientific evidence for precise prevention and control of drug-resistant tuberculosis.
Data from 21 351 bacteriologically confirmed pulmonary tuberculosis patients registered in Changsha from 2018 to 2025 were collected from the "China Disease Prevention and Control Information System". The completion of drug resistance screening, mycobacterial species distribution, drug resistance spectrum characteristics, and resistance trends of 5 anti-tuberculosis drugs were analyzed. The Cochran-Armitage trend test was used to compare annual changes, and multivariate Logistic regression analysis was used to identify influencing factors of rifampicin resistance.
From 2018 to 2025, the average drug resistance screening rate among bacteriologically confirmed pulmonary tuberculosis patients in Changsha was 90.82%, showing a significant increasing trend (P<0.001). A total of 17 439 isolates underwent mycobacterial species identification, of which 17 034 (97.68%) were identified as Mycobacterium tuberculosis complex. The proportion of non-tuberculous mycobacteria showed a decreasing trend (P<0.001). The overall drug resistance rate was 10.27%, including mono-resistance 7.25%, poly-resistance 0.71%, RFP resistance 4.31%, multidrug resistance 2.31%, pre-extensively drug-resistant tuberculosis rate was 0.29%, and extensive drug-resistant tuberculosis rate was 0.04%. The overall drug resistance rate, mono-resistance rate, and pre-extensively drug-resistant rate showed slight decreasing trends (all P<0.05). The resistance rates to 5 drugs ranked as follows: Isoniazid (INH; 8.84%), rifampicin (4.31%), ofloxacin (OFX; 2.54%), ethambutol (EMB; 1.87%), and kanamycin (KM; 0.52%). The isoniazid resistance rate showed a significant increasing trend (average annual increase of 1.47%, P<0.001). The drug resistance spectrum was dominated by mono-resistance (7.28%), and the most common multidrug resistance combination was RFP+INH (1.29%). Multivariate Logistic regression analysis showed that patients aged 25-44 years (OR=1.23, 95% CI 1.05 to 1.43) and previously treated patients (OR=1.76, 95% CI 1.61 to 1.94) had a higher risk of rifampicin resistance, while patients aged ≥65 years had a lower risk (OR=0.72, 95% CI 0.61 to 0.85).
The drug resistance level of pulmonary tuberculosis in Changsha from 2018 to 2025 was generally stable. However, the RFP resistance rate among new patients was higher than the global and national levels, and the continuous increase in INH resistance rate requires heightened attention. Young and middle-aged adults aged 25-44 years and previously treated patients are high-risk populations for RFP resistance and should be prioritized for drug resistance monitoring and precise intervention.
PMID:
42565573
Bibliographic data and abstract were imported from PubMed on 07 Aug 2026.
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