Risk factors of multidrug‐resistant tuberculosis in China: A meta‐analysis

Feng, Mei; Xu, Yuangao; Zhang, XiangYan; Qiu, Qian; Lei, Shiguang; Li, Jinlan; Wei, Yuan; Song, QunFeng; Xu, Junqiang

doi:10.1111/phn.12582

Cited by 19 publications

(16 citation statements)

References 24 publications

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“…Cavitary tuberculosis is caused by lung injury, and reflects macroscopic openings developed between the infection site and the airways that promote bacterial expectoration [ 50 ]. These cavities may remain for a long time in case of inappropriate treatment; cavity wall thickening might occur, as well as fibrotic lesions, which may progress to chronic fiber cavity pulmonary TB [ 8 ]. Drugs administered orally or intravenously rarely achieve effective circulating concentrations in cavities, promoting MDR occurrence [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for multidrug-resistant tuberculosis: A worldwide systematic review and meta-analysis

Xiao¹,

Zhang²,

Qiao³

et al. 2022

PLoS ONE

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Background Since multidrug-resistant tuberculosis (MDR-TB) is a significant public health problem worldwide, identifying associated risk factors is critical for developing appropriate control strategies. Methods A systematic review and meta-analysis was conducted for identifying factors independently predicting MDR-TB. The random-effects model was used to determine pooled odds ratios (ORs) and respective 95% confidence intervals (CIs) for the related factors. Results Of the 2301 retrieved reports, 28 studies were analyzed, assessing 3152 MDR-TB and 52715 DS-TB cases. Totally 22 related factors were analyzed. The pooled ORs were 1.478 (95%CI 1.077–2.028) for positive sputum AFB smear, 1.716 (95%CI 1.149–2.564) for lung cavity, 6.078 (95%CI 2.903–12.725) for previous TB disease and 5.427 (95%CI 3.469–8.490) for a history of anti-TB therapy. All Z test p values were below 0.05, indicating these parameters were significantly associated with MDR-TB. Conclusions Positive sputum AFB smear, lung cavity, previously diagnosed TB and a history of anti-TB therapy are significant risk factors for MDR-TB, which are independent of the clinical setting worldwide. Increased attention should be paid to cases with such parameters to achieve more effective TB control and avoid MDR-TB through the development of a global policy.

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Section: Discussionmentioning

confidence: 99%

Risk factors for multidrug-resistant tuberculosis: A worldwide systematic review and meta-analysis

Xiao¹,

Zhang²,

Qiao³

et al. 2022

PLoS ONE

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“…Retreatment, RR-TB and EPTB are negative factors affecting the treatment outcome and prognosis of patients. Previous treatment history has been a well-known risk factor associated with drug-resistant TB including RR-TB 21 – 23 . Our result that patients between 21 and 40 years of age had higher odds of being RR-TB compared to those 20 years and younger was consistent with past studies 21 , 24 , 25 .…”

Section: Discussionmentioning

confidence: 99%

Upward trends in new, rifampicin-resistant and concurrent extrapulmonary tuberculosis cases in northern Guizhou Province of China

Chen

Tian

et al. 2021

Sci Rep

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Similar to global trends, the incidence rate of tuberculosis (TB) in China declined from 2000 to 2018. In this study, we aimed to evaluate TB trends in northern Guizhou Province and identify risk factors associated with rifampicin-resistant (RR) and concurrent extrapulmonary TB (EPTB). We analyzed data of TB patients hospitalized in Affiliated Hospital of Zunyi Medical University from 2011 to 2018, and assessed correlations between demographic characteristics of patients and RR-TB as well as concurrent EPTB. Our results showed that numbers of new, retreated, RR-TB and concurrent EPTB cases increased gradually from 2011 to 2018. Retreated patients had the highest odds of RR-TB but a lower likelihood of concurrent EPTB compared to new patients. Patients between 21 and 40 years of age had a higher likelihood of RR-TB compared to those 20 years and younger. Female patients and patients from Bijie city as well as the Miao ethnic minority had higher odds of concurrent EPTB. In summary, our data demonstrate upward trends in new, rifampicin-resistant and concurrent extrapulmonary TB cases in northern Guizhou Province of China, which should not be overlooked especially during and post the COVID-19 pandemic because TB is a greater long-term global health threat than COVID-19.

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“…China has the second highest incidence of MDR/RR-TB, accounted for 14% of global MDR/RR-TB patients [1]. A meta-analysis about risk factors of MDR-TB in China showed that Han ethnic group, history of tuberculosis treatment, pulmonary cavity, migrant population, TB case contact history, living in rural areas and low income were considered to be at risk of MDR-TB [27,28]. In Golmud city, 40% previously treated cases are MDR/RR-TB.…”

Section: Discussionmentioning

confidence: 99%

Assessment The Burden of Recent Transmission of M. Tuberculosis Using WGS Analysis In Golmud City In China

Liu

Fan

et al. 2021

Preprint

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Background: Whole genome based Mycobacterium tuberculosis (Mtb) surveillance is facilitated to tuberculosis control. The proportion of genotypic clusters in a population represents the recent transmission rate of Mtb.Methods: We did a population based study of culture-positive Mtb in Golmud, Qinghai, China. Whole-genome sequencing (WGS) was used to discriminate the apparent genetic clusters and resistant associated genes of Mtb, and the risk of genomically clustered Mtb was analyzed combined with epidemiological data. Results: A total of 133 cases of culture-positive tuberculosis were recorded between Jan 1, 2013 and Dec 31, 2018, 17 (13%, 17/133) cases of which were multidrug-resistant/rifampicin tuberculosis (MDR/RR-TB). Patients who were previous treatment or were younger than 35 years had high risk of MDR/RR-TB. 62 (47%, 62/132) strains were in 23 genomic clusters that differed by 12 or fewer single nucleotide polymorphisms (SNPs), indicating recent transmission. Patients who were Tibetan nationality, or those 35-44 years old were more likely to have recent transmission. 15 (65%, 15/23) patients with genotypic rifampin resistant tuberculosis have epidemiological link. Mutation of rifampicin resistance associated genes in rpoB Ser450Leu was showed lower cluster rate (42%, 5/12) compared with other mutations.Conclusions: Recent transmissions of Mtb strains, especially genotypic MDR/RR strains, drive the tuberculosis epidemic in Golmud, Qinghai, China.

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Risk factors of multidrug‐resistant tuberculosis in China: A meta‐analysis

Cited by 19 publications

References 24 publications

Risk factors for multidrug-resistant tuberculosis: A worldwide systematic review and meta-analysis

Risk factors for multidrug-resistant tuberculosis: A worldwide systematic review and meta-analysis

Upward trends in new, rifampicin-resistant and concurrent extrapulmonary tuberculosis cases in northern Guizhou Province of China

Assessment The Burden of Recent Transmission of M. Tuberculosis Using WGS Analysis In Golmud City In China

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