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Prevalence and Risk Factors of primary drug-Resistant Tuberculosis in China

Biomedical and Environmental Sciences 2016年第2期29卷 91-98页

作者： WANG Sheng Fen ZHOU Yang PANG Yu ZHENG Hui Wen ZHAO Yan Lin National Center for Tuberculosis Control and Prevention Chinese Center for Disease Control and Prevention

Objective To investigate the prevalence of primary drug-resistant tuberculosis（TB） and associated risk factors in China. We also explored factors contributing to the transmission of multidrug-resistant tuberculosis（MDR-TB）. Methods A total of 2794 representative, Mycobacterium tuberculosis isolates from treatment-naive patients were subjected to drug susceptibility testing, and risk factors for drug-resistant TB were analyzed. We also analyzed MDR-TB strain sublineages, drug-resistance-conferring mutations, and risk factors associated with clustered primary MDR strains. Results Among 2794 Mycobacterium tuberculosis isolates from treatment-naive patients, the prevalence of any resistance to first-line drugs was 33.2% and the prevalence of MDR-TB was 5.7%. We did not find any risk factors significantly associated with resistance to first-line drugs. The 93 primary MDR-TB isolates were classified into six sublineages, of which, 75（80.6%） isolates were the RD105-deleted Beijing lineage. The largest sublineage included 65（69.9%） isolates with concurrent deletions of RD105, RD207, and RD181. Twenty-nine（31.2%） primary MDR strains grouped in clusters; MDR isolates in clusters were more likely to have S531 L rpoB mutation. Conclusion This study indicates that primary drug-resistant TB and MDR-TB strains are prevalent in China, and multiple measures should be taken to address drug-resistant TB.

关键词： Mycobacterium tuberculosis primary drug resistance Multi-drug resistant tuberculosis

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MODELING primary AND SECONDARY drug resistanceS UNDER CHINA^S ＂FOUR-FREE-ONE-CARE POLICY＂

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International Journal of Biomathematics 2012年第5期5卷 1-19页

作者： JIE LOU LINGCHEN BU ESTHER HAN YUHUA RUAN HUI XING YIMING SHAO Department of Mathematics Shanghai University99 Shangda Road Shanghai 200~ P. R. China Texas College of Osteopathic MedicineUniversity of North Texas Health Science Center Fort Worth TX USA State Key Laboratory for Infectious Disease Control and Prevention andNational Center for AIDS//STD Control and Prevention Chinese Center for Disease Control and Prevention 155 Changbai Road Changping District Beijing 102206 P. R. China

We propose a mathematical model to evaluate the effect of China＇s ＂Four-Free-One-Care Policy＂ in MSM population in Beijing. We divided the drug resistant H[V patients into two sub-populations： primary drug resistance and secondary drug resistance. Uncertainty and sensitivity analysis based on Latin Hypercube Sampling （LHS） were used for these thresholds of our model. We find that drug-resistant HIV will spread fast in MSM population under China＇s current treatment policy. Especially＇, primary-resistant strain is very likely to dominate the HIV positive MSM individuals after 10 years. The conclusions hint that, China＇s outlook on HIV infections is not optimistic if sufficient kinds free second-line drugs in China cannot be put into use in the near future.

关键词： HIV Latin Hypercube Sampling primary drug resistance secondary drugresistance.

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