Transmission of fluoroquinolones resistance among multidrug-resistant tuberculosis in Shanghai, China : a retrospective population-based genomic epidemiology study
Fluoroquinolones (FQ) are essential for the treatment of multidrug-resistant tuberculosis (MDR-TB). The FQ resistance (FQ-R) rate in MDR-TB in China and its risk factors remain poorly understood. We conducted a retrospective, population-based genomic epidemiology study of MDR-TB patients in Shanghai, China, from 2009 to 2018. A genomic cluster was defined as strains with genetic distances ≤ 12 single nucleotide polymorphisms. The transmitted FQ-R was defined as the same FQ resistance-conferring mutations shared by ≥ 2 strains in a genomic cluster. We used multivariable logistic regression analysis to identify the risk factors for drug resistance. Among the total 850 MDR-TB patients included in the study, 72.8% (619/850) were male, the median age was 39 (interquartile range 28, 55) years, 52.7% (448/850) were migrants, and 34.5% (293/850) were previously treated patients. Most of the MDR-TB strains belong to the Beijing lineage (91.7%, 779/850). Overall, the genotypic resistance rate of FQ was 34.7% (295/850), and 47.1% (139/295) FQ-R patients were in genomic clusters, of which 98 (33.2%, 98/295) were presumed as transmitted FQ-R. Patients with treatment-naïve (aOR = 1.84; 95% CI: 1.09, 3.16), diagnosed in a district-level hospital (aOR = 2.69; 95% CI: 1.56, 4.75), and streptomycin resistance (aOR = 3.69; 95% CI: 1.65, 9.42) were significantly associated with the transmission of FQ-R. In summary, the prevalence of FQ-R among MDR-TB patients was high in Shanghai, and at least one-third were transmitted. Enforced interventions including surveillance of FQ drug susceptibility testing and screening among MDR-TB before initiation of treatment were urgently needed.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
Emerging microbes & infections - 13(2024), 1 vom: 01. Jan., Seite 2302837 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Li, Minjuan [VerfasserIn] |
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| Links: |
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| Themen: |
Antitubercular Agents |
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| Anmerkungen: |
Date Completed 24.01.2024 Date Revised 27.01.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1080/22221751.2024.2302837 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366961152 |
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| 245 | 1 | 0 | |a Transmission of fluoroquinolones resistance among multidrug-resistant tuberculosis in Shanghai, China |b a retrospective population-based genomic epidemiology study |
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| 520 | |a Fluoroquinolones (FQ) are essential for the treatment of multidrug-resistant tuberculosis (MDR-TB). The FQ resistance (FQ-R) rate in MDR-TB in China and its risk factors remain poorly understood. We conducted a retrospective, population-based genomic epidemiology study of MDR-TB patients in Shanghai, China, from 2009 to 2018. A genomic cluster was defined as strains with genetic distances ≤ 12 single nucleotide polymorphisms. The transmitted FQ-R was defined as the same FQ resistance-conferring mutations shared by ≥ 2 strains in a genomic cluster. We used multivariable logistic regression analysis to identify the risk factors for drug resistance. Among the total 850 MDR-TB patients included in the study, 72.8% (619/850) were male, the median age was 39 (interquartile range 28, 55) years, 52.7% (448/850) were migrants, and 34.5% (293/850) were previously treated patients. Most of the MDR-TB strains belong to the Beijing lineage (91.7%, 779/850). Overall, the genotypic resistance rate of FQ was 34.7% (295/850), and 47.1% (139/295) FQ-R patients were in genomic clusters, of which 98 (33.2%, 98/295) were presumed as transmitted FQ-R. Patients with treatment-naïve (aOR = 1.84; 95% CI: 1.09, 3.16), diagnosed in a district-level hospital (aOR = 2.69; 95% CI: 1.56, 4.75), and streptomycin resistance (aOR = 3.69; 95% CI: 1.65, 9.42) were significantly associated with the transmission of FQ-R. In summary, the prevalence of FQ-R among MDR-TB patients was high in Shanghai, and at least one-third were transmitted. Enforced interventions including surveillance of FQ drug susceptibility testing and screening among MDR-TB before initiation of treatment were urgently needed | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Zhang, Yangyi |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Zheyuan |e verfasserin |4 aut | |
| 700 | 1 | |a Jiang, Yuan |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Ruoyao |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Jinghui |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Jing |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Honghua |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Rui |e verfasserin |4 aut | |
| 700 | 1 | |a Jiang, Qi |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Lili |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Xiaocui |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Fangyou |e verfasserin |4 aut | |
| 700 | 1 | |a Yuan, Jianhui |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Chongguang |e verfasserin |4 aut | |
| 700 | 1 | |a Shen, Xin |e verfasserin |4 aut | |
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