Analysis of Drug-Resistant Tuberculosis in Children in Shenyang, China, 2017–2021

Sun, Jiao; Fan, Lichao; Zhao, Yanping; Wu, Haoyu; Li, Ran; Tian, Yao; Cheng, Moxin; Ma, Xin; Ma, Yingying; Yang, Xinru; Shen, Adong; Yu, Yanhong; Chen, Yu

doi:10.2147/idr.s428720

Cited by 2 publications

(1 citation statement)

References 33 publications

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“…[ 6 ] Between 2017 and 2021, the rates of DR-TB was 28.78%, and the rates of MR-TB was 12.9% in Shengyang Province, China. [ 7 ] A retrospective study on the epidemiological characteristics and characteristics of DR-TB in children with tuberculosis in Sichuan Province from 2015 to 2018 showed that the culture-confirmed tuberculosis in children accounted for 3% of all new tuberculosis cases, which was lower than the estimated proportion of tuberculosis in children in China, with the overall rate of DR-TB at 24.3% and the rate of MDR-TB at 5.4%. [ 8 ] The analysis by Zignol et al [ 9 ] found that the risk of MDR-TB was similar in children between under 5 years and 5 to 14 years of age.…”

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confidence: 99%

Trends and risk factors for drug-resistant tuberculosis among children in Sichuan, China: A 10-year retrospective analysis, 2013–2022

Li,

Deng,

Huang

et al. 2024

Medicine

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To investigate the status of the drug-resistant tuberculosis (DR-TB) among children in Sichuan, and to find out the risk factors and high-risk population related to drug resistance among children. The clinical data of tuberculosis patients ≤14 years old with culture-confirmed tuberculosis hospitalized in Chengdu Public Health Clinical Center from January 2013 through December 2022 were collected. Clinical data such as gender, age, ethnicity, history of anti-TB treatment, history of exposure to tuberculosis, nutritional status, and specific drug resistance of the children were collected and recorded. The drug resistance of children in different age groups (0–4 years old, 5–9 years old, 10–14 years old) and different periods (2013–2017 and 2018–2022) were grouped and compared. Logistic regression analysis was to analyze analysis of risk factors of drug resistance in children. A total of 438 children with culture-confirmed tuberculosis were screened. Among them, 26.19% (11/42) were 0 to 4 years old, 33.33% (22/66) were 5 to 9 years old, and 36.67% (121/330) were 10 to 14 years old among the resistant children. There was no statistically significant difference in the resistance rate among the 3 groups (P = .385). The proportions of DR-TB, monoresistant tuberculosis, polydrug-resistant tuberculosis were decreased during 2019 to 2022 compared with 2013 to 2017 (P < .0001). The resistance rates of drug resistant, monoresistant, polydrug-resistant, isoniazid-resistant, and rifampicin resistant during 2018 to 2022 were decreased compared with those from 2013 to 2017 (P < .05), but the multi-drug resistance rate was not decreased (P = .131, without statistical difference). The results of logistic regression analysis showed that male gender OR = 1.566 (95% CI 1.035–2.369), a history of antituberculosis therapy OR = 4.049 (95% CI 1.442–11.367), and pulmonary and extrapulmonary tuberculosis OR = 7.335 (95% CI 1.401–38.392) were risk factors for the development of drug resistance; but fever OR = 0.581 (95% CI 0.355–0.950) was Protective factor. The total drug resistance rate of children in Sichuan showed a downward trend, but the rate of multi-drug-resistant tuberculosis was still at a high level, and the form of drug resistance was still severe. Absence of fever, male, retreatment, and pulmonary concurrent with extrapulmonary tuberculosis are risk factors for DR-TB in children.

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Section: Introductionmentioning

confidence: 99%

Trends and risk factors for drug-resistant tuberculosis among children in Sichuan, China: A 10-year retrospective analysis, 2013–2022

Li,

Deng,

Huang

et al. 2024

Medicine

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Modern View on the Problem of Antibiotic Resistance in Pulmonology and Phthisiatry (Literature Review)

Pylypiv,

Piskur

2024

EUMJ

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Introduction. The problem of antibiotic resistance (AR) is threatening for patients with respiratory tract diseases (RTD). The use of antibiotics in the treatment of pneumonia, which can be prescribed in the schemes for the tuberculosis (TB) treatment, creates the prerequisites for the formation of chemoresistance of mycobacterium tuberculosis (MBT). The purpose of our research is to analyze the scientific literature on the causes and factors of the occurrence of AR of the сommon RTD pathogens (pneumonia, tuberculosis). Materials and methods. The information on AR of pneumonia and tuberculosis causative agents obtained from scientific publications published in the «pubmed» and «scopus» databases has been analyzed. Results. The main factors causing AR in European countries today are: low awareness of the public and medical professionals about AR, over-the-counter purchase of antibiotics, use of antibiotic residues, the desire of doctors to avoid complications of the disease, advertising of pharmaceutical products, frequent lack of diagnostic tests to detect common infections. The vast majority of antibiotic prescriptions in ambulatory practice are for the treatment of respiratory tract infections, but up to 90% of them are unwarranted. Сoncomitant diseases of the patient (chronic kidney disease, bronchopulmonary diseases, liver diseases), previous colonization of the oropharynx with AR pathogens, bedridden state, age up to 2 years can be risk factors for AR of pneumonia pathogens. The physician should be alert for M. tuberculosis infection and perform appropriate diagnosis in patients with suspected pneumonia, especially in children, the elderly, and patients with HIV and comorbidities. It has been established that less than 65 years of age, living in a large family, history of TB treatment, contact with TB patients, history of hospitalization and visits to medical institutions, TB/HIV co‑infection, bad habits (smoking, alcohol consumption), glycosylated hemoglobin level ˃ 7% were risk factors for chemoresistant TB in adults. Risk factors for chemoresistant extrapulmonary TB in children were: up to 1 year of age, living in a village, poor family income, contact with bacterial isolates of resistant MBT strains, lack of BCG vaccination, concomitant pathology. Conclusions. In order to reduce the prevalence of AR of the RTD pathogens, clear algorithms for prescribing antibiotics should be developed, patients should be trained in their correct use, and methods of diagnosing common infections should be improved. In order to overcome CR TB, it is necessary to detect patients in time and block the transmission of infection, develop clear control algorithms for the detection and treatment of CR TB in risk groups, for example, among patients with diabetes, intensify the development of drugs with new mechanisms of action, initiate testing for the detection of TB in risk groups with suspected pneumonia.

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Analysis of Drug-Resistant Tuberculosis in Children in Shenyang, China, 2017–2021

Cited by 2 publications

References 33 publications

Trends and risk factors for drug-resistant tuberculosis among children in Sichuan, China: A 10-year retrospective analysis, 2013–2022

Trends and risk factors for drug-resistant tuberculosis among children in Sichuan, China: A 10-year retrospective analysis, 2013–2022

Modern View on the Problem of Antibiotic Resistance in Pulmonology and Phthisiatry (Literature Review)

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