Epidemiology of drug-resistant tuberculosis in Chongqing, China: a retrospective observational study from 2010 to 2017

Wu, Bo; Yu, Yang; Du, Chenqiu; Liu, Ying; Hu, Daiyu

doi:10.1101/610048

Cited by 3 publications

(3 citation statements)

References 17 publications

(6 reference statements)

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“…In our model, the score of MDR-TB is lower, and the score of XDR-TB is higher, i.e., the prognosis of MDR-TB is better than that of XDR-TB. Some published studies have proved that the prognosis of XDR-TB patients is generally worse than that of MDR-TB patients (Chaves Torres et al, 2019;Riccardi et al, 2019;Wu et al, 2019). Our nomogram also demonstrated this point.…”

Section: Discussionsupporting

confidence: 76%

Predicting treatment failure risk in a Chinese Drug-Resistant Tuberculosis with surgical therapy: Development and assessment of a new predictive nomogram

Chang

Song

et al. 2020

International Journal of Infectious Diseases

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Background: The aim of this study was to develop and internally validate a treatment failure risk nomogram in a Chinese population of patients with Drug-Resistant Tuberculosis with surgical therapy. Methods: We developed a prediction model based on a dataset of 132 drug-resistant tuberculosis (DR-TB) patients. The least absolute shrinkage and selection operator regression model was used to optimize feature selection for the treatment failure risk model. Multivariable logistic regression analysis was applied to build a predicting model incorporating the feature selected in the least absolute shrinkage and selection operator regression model. Discrimination, calibration, and clinical usefulness of the predicting model were assessed using the C-index, calibration plot, and decision curve analysis. Internal validation was assessed using the bootstrapping validation. Findings: Predictors contained in the prediction nomogram included Lesion, Treatment history, Recurrent chest infection (RCI) and Multidrug-resistant tuberculosis (MDR-TB) or Extensively drug-resistant tuberculosis (XDR-TB). The model displayed good discrimination with a C-index of 0.905 and good calibration. A high C-index value of 0.876 could still be reached in the interval validation. Decision curve analysis showed that the nomogram was clinically useful when an intervention was decided at the treatment failure possibility threshold of 1%. Interpretation: This study developed a novel nomogram with relatively good accuracy to help clinicians access the risk of treatment failure in MDR/XDR-TB patients when starting surgery. With an estimate of individual risk, clinicians and patients can make more suitable decisions regarding surgery. This nomogram requires external validation, and further research is needed to determine whether the nomogram is appropriate for predicting surgery risk in MDR/XDR-TB patients.

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Section: Discussionsupporting

confidence: 76%

Predicting treatment failure risk in a Chinese Drug-Resistant Tuberculosis with surgical therapy: Development and assessment of a new predictive nomogram

Chang

Song

et al. 2020

International Journal of Infectious Diseases

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“…Additionally, Sichuan has a high incidence of TB of approximately 100 cases per 100 000 people [7], with the second highest TB caseload among the provinces in China [8, 9]. Furthermore, the extensively drug-resistant (XDR)-TB notification rate significantly increased from 2010 to 2017 in Southwest China [10]. Approximately 9% of incident TB cases worldwide are among patients with HIV infection [11].…”

Section: Introductionmentioning

confidence: 99%

Drug resistance characteristics of Mycobacterium tuberculosis isolates obtained between 2018 and 2020 in Sichuan, China

et al. 2022

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We investigated the drug resistance of Mycobacterium tuberculosis isolates from patients with tuberculosis (TB) and HIV, and those diagnosed with only TB in Sichuan, China. TB isolates were obtained from January 2018 to December 2020 and subjected to drug susceptibility testing (DST) to 11 anti-TB drugs and to GeneXpert MTB/RIF testing. The overall proportion of drug-resistant TB (DR-TB) isolates was 32.1% (n=10,946). HIV testing was not universally available for outpatient TB cases, only 29.5% (3,227/10,946) cases had HIV testing results. The observed proportion of multidrugresistant TB (MDR-TB) isolates was almost double than that of the national level, with approximately 1.5% and 0.1% of the isolates being extensively drug resistant and universally drug resistant, respectively. The proportions of resistant isolates were generally higher in 2018 and 2019 than in 2020. Furthermore, the sensitivities of GeneXpert during 2018-2020 demonstrated a downward trend (80.9 [95% confidence intervals (CI): 76.8-85.0], 80.2 [95% CI: 76.4-84.1], and 75.4 [95% CI: 70.7-80.2], respectively). Approximately 69.0% (7,557/10,946) of the TB cases with DST results were subjected to GeneXpert detection. Overall, the DR-TB status and the use of GeneXpert in Sichuan have improved, but DR-TB challenges remain. HIV testing for all TB cases is recommended.

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“…increased from 2010 to 2017. 8 However, the current prevalence trend of DR-TB, especially MDR/XDR-TB, in Chongqing, is still poorly known.…”

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confidence: 99%

Characteristics and Trend of Drug-Resistant Tuberculosis at a Major Specialized Hospital in Chongqing, China: 2016 Versus 2019

Zhang

Yang

et al. 2022

Disaster med. public health prep.

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Objective: The epidemic of drug-resistant tuberculosis (DR-TB) has become a major concern in global TB control. This study aimed to investigate the patterns and trend of DR-TB epidemic between different time periods in Chongqing. Methods: A total of 985 and 835 culture positive TB patients with drug susceptibility testing (DST) results admitted to the hospital in 2016 and 2019, respectively, were included. Chi-square testing was used to compare the prevalence and trends of DR-TB in 2016 and 2019. Results: The proportion of previously treated TB cases with culture positivity was 45.7% in 2019, significantly higher than that in 2016 (39.1%, P = 0.004). The overall rate of drug resistance in 2019 was 43.1%, higher than that in 2016 (40.2%). The rates of multi-drug resistant TB (MDR-TB) and pre-extensively drug resistant TB (pre-XDR-TB) increased significantly from 2016 to 2019 among all TB cases (MDR: 25% vs 33.4%, P < 0.001 and pre-XDR: 7.1% vs 12.8%, P < 0.001, respectively) and previously treated TB cases (MDR: 46.5% vs 56%, P = 0.008 and pre-XDR: 13.2% vs 21.5%, P = 0.003, respectively). Conclusions: Our findings indicated that the prevalence of DR-TB remains high in Chongqing. The trend of resistance to anti-TB drugs beccame worse between 2016 and 2019. Moreover, acquired MDR may play a major role in MDR-TB epidemic in Chongqing. Therefore, rapid diagnosis and effective treatment of TB patients will be important to reduce the burden of DR-TB in Chongqing.

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Epidemiology of drug-resistant tuberculosis in Chongqing, China: a retrospective observational study from 2010 to 2017

Cited by 3 publications

References 17 publications

Predicting treatment failure risk in a Chinese Drug-Resistant Tuberculosis with surgical therapy: Development and assessment of a new predictive nomogram

Predicting treatment failure risk in a Chinese Drug-Resistant Tuberculosis with surgical therapy: Development and assessment of a new predictive nomogram

Drug resistance characteristics of Mycobacterium tuberculosis isolates obtained between 2018 and 2020 in Sichuan, China

Characteristics and Trend of Drug-Resistant Tuberculosis at a Major Specialized Hospital in Chongqing, China: 2016 Versus 2019

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