Analysis of Drug Resistance Characteristics of Mycobacterium Tuberculosis in Anhui Province, 2016-2022

Figures & data

Table 1 Characteristics of 2336 Mycobacterium Tuberculosis Isolates from Anhui Province Drug Resistance Surveillance Sites, 2016–2022

	Category	Quantity
		Total	Initial Treatment	Retreatment
	Number of strains	2336	2071	265
Gender	Male	1788	1564	224
	Female	548	507	41
Age	0–19	39	39	0
	20–39	354	323	31
	40–59	642	566	76
	60~	1301	1143	158
Address	Town	801	668	133
	Country	1535	1403	132
Nationality	Han	2326	2062	264
	Other	10	9	1
Profession	Farmers	1483	1339	144
	Corporate Employees	110	97	13
	Commercial Service Personnel	70	66	4
	Medical and Health Personnel	8	7	1
	Educators	7	6	1
	Government and Public Institutions	11	11	0
	Transportation Industry	17	16	1
	Retirees	260	209	51
	Laid-off Workers	216	180	36
	Students	43	42	1
	Others	111	98	13
Educational level	Illiteracy	663	602	61
	Primary school	730	646	84
	Middle school	558	481	77
	High technical secondary school	285	248	37
	College or above	100	94	6
Medical Insurance	Without	34	31	3
	Urban staff	388	321	67
	Urban residents	375	321	54
	New rural cooperative medical system (NCMS)	1534	1393	141
	Commercial insurance	1	1
	Others	4	4
Presence of diabetes mellitus	Yes	285	237	48
	No	1988	1774	214
	Unknown	63	60	3
Whether combined with hepatitis B	Yes	38	31	7
	No	2218	1972	246
	Unknown	80	68	12
Annual household income	~20,000	661	586	75
	20,001~40,000	748	667	81
	40,001~60,000	493	431	63
	60,001~	434	387	46
Family size (persons)	1	123	107	16
	2	733	619	114
	3	651	586	65
	4	496	457	39
	5	246	222	24
	6	61	55	6
	7	16	15	1
	8	9	9
	9	1	1

Table 2 Drug Resistance Spectrum of 2336 Strains of Mycobacterium Tuberculosis in Drug Resistance Monitoring Sites of Anhui Province from 2016 to 2022

	Total		Initial treatment		Retreatment
	Number of Drug-resistant Strains	Drug Resistance Rate (%)	Number of Drug-resistant Strains	Drug Resistance Rate (%)	Number of drug-resistant Strains	Drug Resistance Rate (%)
Single drug resistance
INH	236	10.55%	177	8.55%	59	22.26%
RFP	133	5.95%	86	4.15%	47	17.74%
SM	183	8.18%	142	6.86%	41	15.47%
EMB	53	2.37%	32	1.55%	21	7.92%
KM	44	1.97%	33	1.59%	11	4.15%
OFX	146	6.53%	112	5.41%	34	12.83%
Multi-drug resistant tuberculosis
INH+SM	96	4.11%	70	3.38%	26	9.81%
INH+EMB	44	1.88%	26	1.26%	18	6.79%
INH+KM	33	1.41%	26	1.26%	7	2.64%
INH+OFX	55	2.35%	35	1.69%	20	7.55%
SM+EMB	34	1.46%	19	0.92%	15	5.66%
SM+KM	22	0.94%	17	0.82%	5	1.89%
SM+OFX	29	1.24%	18	0.87%	11	4.15%
EMB+KM	18	0.77%	13	0.63%	5	1.89%
EMB+OFX	28	1.20%	16	0.77%	12	4.53%
KM+OFX	24	1.03%	16	0.77%	8	3.02%
INH+SM+KM	21	0.90%	16	0.77%	5	1.89%
INH+SM+OFX	25	1.07%	15	0.72%	10	3.77%
INH+EMB+KM	18	0.77%	13	0.63%	5	1.89%
INH+EMB+OFX	25	1.07%	16	0.77%	9	3.40%
RFP+SM+KM	20	0.86%	15	0.72%	5	1.89%
RFP+SM+OFX	25	1.07%	15	0.72%	10	3.77%
RFP+EMB+KM	17	0.73%	12	0.58%	5	1.89%
RFP+EMB+OFX	24	1.03%	14	0.68%	10	3.77%
INH+SM+EMB+KM	15	0.64%	10	0.48%	5	1.89%
INH+SM+EMB+OFX	21	0.90%	12	0.58%	9	3.40%
RFP+SM+EMB+KM	15	0.64%	10	0.48%	5	1.89%
RFP+SM+EMB+OFX	20	0.86%	11	0.53%	9	3.40%

Table 3 Antimicrobial Resistance Trend Spectrum of 2336 Mycobacterium Tuberculosis Isolates from Anhui Province Surveillance Sites, 2016–2022

Year	Number of Drug-resistant Strains	INH		RFP		SM		EMB		KM		OFX
		Number of Drug-resistant Strains	Drug Resistance Rate (%)	Number of Drug-resistant Strains	Drug Resistance Rate (%)	Number of Drug-resistant Strains	Drug Resistance Rate (%)	Number of Drug-resistant Strains	Drug Resistance Rate (%)	Number of Drug-resistant Strains	Drug Resistance Rate (%)	Number of Drug-resistant Strains	Drug Resistance Rate (%)
2016	286	35	12.24%	24	8.39%	30	10.49%	5	1.75%	7	2.45%	30	10.49%
2017	288	32	11.11%	18	6.25%	23	7.99%	8	2.78%	5	1.74%	22	7.64%
2018	264	37	14.02%	21	7.95%	20	7.58%	8	3.03%	14	5.30%	20	7.58%
2019	354	42	11.86%	21	5.93%	36	10.17%	14	3.95%	8	2.26%	22	6.21%
2020	332	20	6.02%	14	4.22%	27	8.13%	11	3.31%	5	1.51%	18	5.42%
2021	349	27	7.74%	16	4.58%	25	7.16%	3	0.86%	0	0.00%	16	4.58%
2022	463	43	9.29%	19	4.10%	22	4.75%	4	0.86%	5	1.08%	18	3.89%

Figure 1 Drug resistance trend spectrum of 2336 strains of Mycobacterium tuberculosis in drug resistance monitoring sites of Anhui Province from 2016 to 2022.

Table 4 Antimicrobial Resistance Profiles of 2336 Mycobacterium Tuberculosis Isolates from Various Sources at Anhui Province’s Drug Resistance Monitoring Sites Between 2016 and 2022

Source		INH		RFP		SM		EMB		KM		OFX
		Number of Drug-resistant Strains	Drug Resistance Rate (%)	Number of Drug-resistant Strains	Drug Resistance Rate (%)	Number of Drug-resistant Strains	Drug Resistance Rate (%)	Number of Drug-resistant Strains	Drug Resistance Rate (%)	Number of Drug-resistant Strains	Drug Resistance Rate (%)	Number of Drug-resistant Strains	Drug Resistance Rate (%)
Gender
Male	1788	180	10.07%	103	5.76%	147	8.22%	42	2.35%	38	2.13%	111	6.21%
Female	548	56	10.22%	30	5.47%	36	6.57%	11	2.01%	6	1.09%	35	6.39%
χ2		0.011		0.064		1.586		0.413		2.867		0.023
P		0.918		0.800		0.208		0.520		0.090		0.880
Age
0–19	39	2	5.13%	1	2.56%	1	2.56%	2	5.13%	0	0.00%	1	2.56%
20–39	354	31	8.76%	20	5.65%	26	7.34%	5	1.41%	2	0.56%	12	3.39%
40–59	642	85	13.24%	57	8.88%	77	11.99%	22	3.43%	19	2.96%	43	6.70%
≥60	1301	118	9.07%	55	4.23%	79	6.07%	24	1.84%	23	1.77%	90	6.92%
χ2		10.285		18.049		22.596		7.547		8.195		7.056
P		0.016		0.000		0.000		0.056		0.042		0.070
Category
Initial treatment	2071	177	8.55%	86	4.15%	142	6.86%	32	1.55%	33	1.59%	112	5.41%
Retreatment	265	59	22.26%	47	17.74%	41	15.47%	21	7.92%	11	4.15%	34	12.83%
χ2		48.677		80.731		24.150		43.120		8.315		22.088
P		0.000		0.000		0.000		0.000		0.004		0.000
Presence of diabetes mellitus
Yes	285	31	10.88%	26	9.12%	25	8.77%	8	2.81%	8	2.81%	24	8.42%
No	1988	198	9.96%	105	5.28%	152	7.65%	45	2.26%	36	1.81%	120	6.04%
Unknown	63	7	11.11%	2	3.17%	6	9.52%	0	0.00%	0	0.00%	2	3.17%
χ2		0.232		6.772		0.440		0.323		1.303		2.389
P		0.630		0.009		0.507		0.570		0.254		0.122
Address
Town	801	104	12.98%	62	7.74%	82	10.24%	17	2.12%	20	2.50%	65	8.11%
Country	1535	132	8.60%	71	4.63%	101	6.58%	36	2.35%	24	1.56%	81	5.28%
χ2		11.141		9.511		9.751		0.118		2.481		7.235
P		0.001		0.002		0.002		0.731		0.115		0.007
Annual household income
~20,000	661	70	10.59%	39	5.90%	48	7.26%	20	3.03%	13	1.97%	45	6.81%
20,001~40,000	748	70	9.36%	48	6.42%	50	6.68%	17	2.27%	15	2.01%	49	6.55%
40,001~60,000	493	58	11.76%	30	6.09%	49	9.94%	7	1.42%	11	2.23%	26	5.27%
60,001~	434	38	8.76%	16	3.69%	36	8.29%	9	2.07%	5	1.15%	26	5.99%
χ2		2.996		4.178		4.822		3.385		1.664		1.318
P		0.392		0.243		0.185		0.336		0.645		0.725

Table 5 Drug Resistance Spectrum of 98 Strains of MDR-TB in Drug Resistance Monitoring Sites of Anhui Province from 2016 to 2022

	Total		Initial Treatment		Retreatment
	Number of Drug-resistant Strains	Drug Resistance Rate (%)	Number of Drug-resistant Strains	Drug Resistance Rate (%)	Number of Drug-resistant Strains	Drug Resistance Rate (%)
Total	2336		2071		265
MDR	98	4.20%	60	2.90%	38	14.34%
MDR+SM	47	2.01%	29	1.40%	18	6.79%
MDR+EMB	36	1.54%	22	1.06%	14	5.28%
MDR+KM	27	1.16%	20	0.97%	7	2.64%
MDR+OFX	46	1.97%	28	1.35%	18	6.79%
MDR+SM+EMB	29	1.24%	17	0.82%	12	4.53%
MDR+SM+KM	19	0.81%	14	0.68%	5	1.89%
MDR+SM+OFX	23	0.98%	13	0.63%	10	3.77%
MDR+EMB+KM	17	0.73%	12	0.58%	5	1.89%
MDR+EMB+OFX	23	0.98%	14	0.68%	9	3.40%
MDR+SM+EMB+KM	15	0.64%	10	0.48%	5	1.89%
MDR+SM+EMB+OFX	20	0.86%	11	0.53%	9	3.40%
XDR	20	0.86%	13	0.63%	7	2.64%
XDR+SM	15	0.64%	10	0.48%	5	1.89%
XDR+EMB	13	0.56%	10	0.48%	5	1.89%
XDR+SM+EMB	13	0.56%	8	0.39%	5	1.89%

Table 6 Antimicrobial Resistance Trend Spectrum of 98 MDR-TB from Anhui Province Surveillance Sites, 2016–2022

Year	2016	2017	2018	2019	2020	2021	2022
Number of strains	286	288	264	354	332	349	463
Number of MDR-strains	13	16	14	20	10	10	15
Ratio (%)	4.55%	5.56%	5.30%	5.65%	3.01%	2.87%	3.24%

Table 7 Distribution of 98 Strains of MDR-TB from Different Sources in Anhui Province from 2016 to 2022

Source	Gender		Age				Category		Presence of Diabetes Mellitus			Address		Annual Household Income
	Male	Female	0–19	20–39	40–59	≥60	Initial Treatment	Retreatment	Yes	No	Unknown	Town	Country	~20,000	20,001~40,000	40,001~60,000	60,001~
Number of strains	1788	548	39	354	642	1301	2071	265	285	1988	63	801	1535	661	748	493	434
Number of MDR-strains	76	22	0	11	43	44	60	38	20	77	1	44	54	31	30	23	14
Ratio (%)	4.25%	4.01%	0.00%	3.11%	6.70%	3.38%	2.90%	14.34%	7.02%	3.87%	1.59%	5.49%	3.52%	4.69%	4.01%	4.67%	3.23%
χ2	0.058		14.895				76.534		6.032			5.109		1.752
P	0.810		0.002				<0.001		0.014			0.024		0.626

Table 8 Drug Resistance Spectrum of Mycobacterium Tuberculosis with Diabetes Mellitus

Category	Number of Strains	INH	RFP	SM	EMB	KM	OFX	MDR
TB+DM	285	31(10.88)	26(9.12%)	25(8.77%)	8(2.81%)	8(2.81%)	24(8.42%)	20(7.02%)
TB	1988	198(9.96%)	105(5.28%)	152(7.65%)	45(2.26%)	36(1.81%)	120(6.04%)	77(3.87%)
χ2		0.232	6.772	0.440	0.367	1.390	2.389	6.032
P		0.630	0.009	0.507	0.544	0.238	0.122	0.014

Table 9 Distribution of Mycobacterium Tuberculosis with Diabetes Mellitus

Category	Number of Strains	Gender		Age				Category		Address		Annual Household Income
		Male	Female	0–19	20–39	40–59	≥60	Initial Treatment	Retreatment	Town	Country	0–20,000	20,001–40,000	40,001–60,000	≥60,001
TB+DM	285	241	44	3	11	98	173	237	48	151	134	71	73	81	60
TB	1988	1513	475	37	335	537	1079	1774	214	636	1352	561	658	399	370
χ2		10.113		35.284				8.560		48.519		14.338
P		0.001		<0.001				0.003		<0.001		0.002