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Transmission of MDR and XDR tuberculosis in Shanghai, China.

Zhao M, Li X, Xu P, Shen X, Gui X, Wang L, Deriemer K, Mei J, Gao Q - PLoS ONE (2009)

Bottom Line: VNTR-7 and VNTR-16 were used to genotype the strains, and prior treatment history and treatment outcomes were determined for each patient.Nearly 57% of the patients with MDR were successfully treated.Therefore, universal drug susceptibility testing is recommended for new and retreatment TB cases.

View Article: PubMed Central - PubMed

Affiliation: Department of TB Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.

ABSTRACT

Background: Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) are global health problems. We sought to determine the characteristics, prevalence, and relative frequency of transmission of MDR and XDR TB in Shanghai, one of the largest cities in Asia.

Methods: TB is diagnosed in district TB hospitals in Shanghai, China. Drug susceptibility testing for first-line drugs was performed for all culture positive TB cases, and tests for second-line drugs were performed for MDR cases. VNTR-7 and VNTR-16 were used to genotype the strains, and prior treatment history and treatment outcomes were determined for each patient.

Results: There were 4,379 culture positive TB cases diagnosed with drug susceptibility test results available during March 2004 through November 2007. 247 (5.6%) were infected with a MDR strain of M. tuberculosis and 11 (6.3%) of the 175 MDR patients whose isolate was tested for susceptibility to second-line drugs, were XDR. More than half of the patients with MDR and XDR were newly diagnosed and had no prior history of TB treatment. Nearly 57% of the patients with MDR were successfully treated.

Discussion: Transmission of MDR and XDR strains is a serious problem in Shanghai. While a history of prior anti-TB treatment indicates which individuals may have acquired MDR or XDR TB, it does not accurately predict which TB patients have disease caused by transmission of MDR and XDR strains. Therefore, universal drug susceptibility testing is recommended for new and retreatment TB cases.

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Study population of cases of drug resistant tuberculosis in Shanghai, March, 2004–November, 2007.TB = tuberculosis. MDR = multidrug-resistant. MOTT = Mycobacteria other than tuberculosis.
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pone-0004370-g001: Study population of cases of drug resistant tuberculosis in Shanghai, March, 2004–November, 2007.TB = tuberculosis. MDR = multidrug-resistant. MOTT = Mycobacteria other than tuberculosis.

Mentions: From March 2004 through November 2007, there were 19,722 newly registered pulmonary tuberculosis patients in 31 designated district tuberculosis hospitals in Shanghai. Of these, 6,200 (31.4%) patients were culture positive for M. tuberculosis. We excluded 1,537 culture-positive TB patients who were diagnosed during May 2005 through February 2006 because the drug susceptibility testing of their isolates was performed using the absolute concentration method. We compared the characteristics such as sex, age and treatment history of the patients who were included and excluded from the study population and found no significant differences (data not shown). Of the remaining 4,663 TB patients, we further excluded 95 (2.0%) patients whose isolate lacked a drug susceptibility test result and 189 (4.1%) patients who were infected with Mycobacterium other than M. tuberculosis (MOTT). The remaining 4,379 patients with culture-confirmed M. tuberculosis and their drug susceptibility test results were used for analysis. Among them, 247 (5.6%, 247/4,379) TB patients had disease caused by a MDR strain of M. tuberculosis (figure 1).


Transmission of MDR and XDR tuberculosis in Shanghai, China.

Zhao M, Li X, Xu P, Shen X, Gui X, Wang L, Deriemer K, Mei J, Gao Q - PLoS ONE (2009)

Study population of cases of drug resistant tuberculosis in Shanghai, March, 2004–November, 2007.TB = tuberculosis. MDR = multidrug-resistant. MOTT = Mycobacteria other than tuberculosis.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2631152&req=5

pone-0004370-g001: Study population of cases of drug resistant tuberculosis in Shanghai, March, 2004–November, 2007.TB = tuberculosis. MDR = multidrug-resistant. MOTT = Mycobacteria other than tuberculosis.
Mentions: From March 2004 through November 2007, there were 19,722 newly registered pulmonary tuberculosis patients in 31 designated district tuberculosis hospitals in Shanghai. Of these, 6,200 (31.4%) patients were culture positive for M. tuberculosis. We excluded 1,537 culture-positive TB patients who were diagnosed during May 2005 through February 2006 because the drug susceptibility testing of their isolates was performed using the absolute concentration method. We compared the characteristics such as sex, age and treatment history of the patients who were included and excluded from the study population and found no significant differences (data not shown). Of the remaining 4,663 TB patients, we further excluded 95 (2.0%) patients whose isolate lacked a drug susceptibility test result and 189 (4.1%) patients who were infected with Mycobacterium other than M. tuberculosis (MOTT). The remaining 4,379 patients with culture-confirmed M. tuberculosis and their drug susceptibility test results were used for analysis. Among them, 247 (5.6%, 247/4,379) TB patients had disease caused by a MDR strain of M. tuberculosis (figure 1).

Bottom Line: VNTR-7 and VNTR-16 were used to genotype the strains, and prior treatment history and treatment outcomes were determined for each patient.Nearly 57% of the patients with MDR were successfully treated.Therefore, universal drug susceptibility testing is recommended for new and retreatment TB cases.

View Article: PubMed Central - PubMed

Affiliation: Department of TB Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.

ABSTRACT

Background: Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) are global health problems. We sought to determine the characteristics, prevalence, and relative frequency of transmission of MDR and XDR TB in Shanghai, one of the largest cities in Asia.

Methods: TB is diagnosed in district TB hospitals in Shanghai, China. Drug susceptibility testing for first-line drugs was performed for all culture positive TB cases, and tests for second-line drugs were performed for MDR cases. VNTR-7 and VNTR-16 were used to genotype the strains, and prior treatment history and treatment outcomes were determined for each patient.

Results: There were 4,379 culture positive TB cases diagnosed with drug susceptibility test results available during March 2004 through November 2007. 247 (5.6%) were infected with a MDR strain of M. tuberculosis and 11 (6.3%) of the 175 MDR patients whose isolate was tested for susceptibility to second-line drugs, were XDR. More than half of the patients with MDR and XDR were newly diagnosed and had no prior history of TB treatment. Nearly 57% of the patients with MDR were successfully treated.

Discussion: Transmission of MDR and XDR strains is a serious problem in Shanghai. While a history of prior anti-TB treatment indicates which individuals may have acquired MDR or XDR TB, it does not accurately predict which TB patients have disease caused by transmission of MDR and XDR strains. Therefore, universal drug susceptibility testing is recommended for new and retreatment TB cases.

Show MeSH
Related in: MedlinePlus