Drug susceptibility results and clinical characteristics as well as their correlation analysis from 417 cases with positive culture of tubercle bacilli

Abstract：Objective To understand the bacteriology and the association between drug susceptibility and clinical features from recent hospitalization of tuberculosis (TB) patients with positive tuberculosis bacilli culture. Methods We collected the clinical data of inpatients due to tuberculosis or pulmonary disease with positive tuberculosis bacilli by BACTEC960 culture auto-analysis system and possessing anti-tuberculosis drug susceptibility testing results from January 2008 to November 2008. All isolated strains were tested with first-line drugs included Streptomycin (S), Isoniazid(H), Rifampicin (R)and Ethambutol(E). Some isolate strains were used to test Amikacin(Am) ,Capreomycin(Cm)and Ofloxacin(Ofx). We recorded the drug-tested results and clinical data and retrospectively analyzed them. The patients with pulmonary disease from nontuberculosis mycobacteria( NTM) were excluded. Results (1) There were 417 patients with positive culture of tuberculosis bacilli (included 294 male and 123 female). The mean age was(47.8 18.1) years( ranging from 6 to 91 years). There were 68 cases complicated with endobronchial tuberculosis(EBTB) and 56 cases with type 2 diabetes mellitus. (2)There were 271 cases for initial treatment and 146 cases of relapsing tuberculosis. The total drug resistant rate was 53.5 percent,and of oflx was as high as 31.86 percent. The initial drug resistant rate was S 22.5% , H 25.8% , R 17.3% ,E 21.0% , Am 6.3% ,Cm 10.0% ,Ofx 16.6% respectively and the required rate was 67.8% ,82.9% ,68.5% ,68.5% ,19.9% ,25. 3% ,58.2% respectively. (3) There were 143 patients with multidrug resistant TB (MDR-TB). The mean age 44. 59±16. 31 was significantly younger than of other patients (P<0.01 ). The incidence of MDR-TB was 34. 3 percent (initial rate 16.2% and required rate 67.8%). The factors contributed MDR-TB came from treating failure (83.7% ) ,TB relapse in short period(85.2% ) ,self-stop treatment(80.6% ) ,and interval treatment for adverse reactions (27.3% ). Conclusion There were higher incidences of drug resistance and MDR-TB among inpatients. There was a tendency that patients with MDR-TB were younger than others. Female patients and those combined EBTB tended to develop MDR-TB. The compliance of patients taking medicine was relevant to occurrence of MDR-TB. The result of TB treatment may be used as an important standard whether it was MDR-TB.