Objective To investigate the prevalence of primary drug-resistant tuberculosis（TB） and associated risk factors in China. We also explored factors contributing to the transmission of multidrug-resistant tuberculosis...Objective To investigate the prevalence of primary drug-resistant tuberculosis（TB） and associated risk factors in China. We also explored factors contributing to the transmission of multidrug-resistant tuberculosis（MDR-TB）. Methods A total of 2794 representative, Mycobacterium tuberculosis isolates from treatment-naive patients were subjected to drug susceptibility testing, and risk factors for drug-resistant TB were analyzed. We also analyzed MDR-TB strain sublineages, drug-resistance-conferring mutations, and risk factors associated with clustered primary MDR strains. Results Among 2794 Mycobacterium tuberculosis isolates from treatment-naive patients, the prevalence of any resistance to first-line drugs was 33.2% and the prevalence of MDR-TB was 5.7%. We did not find any risk factors significantly associated with resistance to first-line drugs. The 93 primary MDR-TB isolates were classified into six sublineages, of which, 75（80.6%） isolates were the RD105-deleted Beijing lineage. The largest sublineage included 65（69.9%） isolates with concurrent deletions of RD105, RD207, and RD181. Twenty-nine（31.2%） primary MDR strains grouped in clusters; MDR isolates in clusters were more likely to have S531 L rpoB mutation. Conclusion This study indicates that primary drug-resistant TB and MDR-TB strains are prevalent in China, and multiple measures should be taken to address drug-resistant TB.展开更多
We propose a mathematical model to evaluate the effect of China＇s ＂Four-Free-One-Care Policy＂ in MSM population in Beijing. We divided the drug resistant H[V patients into two sub-populations： primary drug resista...We propose a mathematical model to evaluate the effect of China＇s ＂Four-Free-One-Care Policy＂ in MSM population in Beijing. We divided the drug resistant H[V patients into two sub-populations： primary drug resistance and secondary drug resistance. Uncertainty and sensitivity analysis based on Latin Hypercube Sampling （LHS） were used for these thresholds of our model. We find that drug-resistant HIV will spread fast in MSM population under China＇s current treatment policy. Especially＇, primary-resistant strain is very likely to dominate the HIV positive MSM individuals after 10 years. The conclusions hint that, China＇s outlook on HIV infections is not optimistic if sufficient kinds free second-line drugs in China cannot be put into use in the near future.展开更多
基金supported by a research grant from the National Science & Technology Major Project (2014ZX10003001001) and (2014ZX10003002)
文摘Objective To investigate the prevalence of primary drug-resistant tuberculosis（TB） and associated risk factors in China. We also explored factors contributing to the transmission of multidrug-resistant tuberculosis（MDR-TB）. Methods A total of 2794 representative, Mycobacterium tuberculosis isolates from treatment-naive patients were subjected to drug susceptibility testing, and risk factors for drug-resistant TB were analyzed. We also analyzed MDR-TB strain sublineages, drug-resistance-conferring mutations, and risk factors associated with clustered primary MDR strains. Results Among 2794 Mycobacterium tuberculosis isolates from treatment-naive patients, the prevalence of any resistance to first-line drugs was 33.2% and the prevalence of MDR-TB was 5.7%. We did not find any risk factors significantly associated with resistance to first-line drugs. The 93 primary MDR-TB isolates were classified into six sublineages, of which, 75（80.6%） isolates were the RD105-deleted Beijing lineage. The largest sublineage included 65（69.9%） isolates with concurrent deletions of RD105, RD207, and RD181. Twenty-nine（31.2%） primary MDR strains grouped in clusters; MDR isolates in clusters were more likely to have S531 L rpoB mutation. Conclusion This study indicates that primary drug-resistant TB and MDR-TB strains are prevalent in China, and multiple measures should be taken to address drug-resistant TB.
文摘We propose a mathematical model to evaluate the effect of China＇s ＂Four-Free-One-Care Policy＂ in MSM population in Beijing. We divided the drug resistant H[V patients into two sub-populations： primary drug resistance and secondary drug resistance. Uncertainty and sensitivity analysis based on Latin Hypercube Sampling （LHS） were used for these thresholds of our model. We find that drug-resistant HIV will spread fast in MSM population under China＇s current treatment policy. Especially＇, primary-resistant strain is very likely to dominate the HIV positive MSM individuals after 10 years. The conclusions hint that, China＇s outlook on HIV infections is not optimistic if sufficient kinds free second-line drugs in China cannot be put into use in the near future.
