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Abstract：
To investigate the positivity rates and drug resistance characteristics of Mycobacterium tuberculosis (MTB) among suspected tuberculosis (TB) patients in Shandong Province, the second-largest population province in China.
A prospective, multi-center study was conducted from April 2022 to June 2023. Pathogen and drug resistance were identified using nucleotide matrix-assisted laser desorption ionization time-of-flight mass spectrometry (nucleotide MALDI-TOF MS).
Of 940 suspected TB patients included in this study, 552 cases were found to be infected with MTB giving an overall positivity rate of 58.72%. Total of 346 cases were resistant to arbitrary anti-TB drug (62.68%), with Zibo (76.47%), Liaocheng and Weihai (both 69.23%) ranking top three and TB treatment history might be a related factor. Monoresistance was the most common pattern (33.53%), with isoniazid the highest at 12.43%, followed by rifampicin at 9.54%. Further analysis of gene mutations conferring resistance revealed diverse types with high heteroresistance rate found in multiple anti-TB drugs.
A relatively high rate of MTB positivity and drug resistance was found in Shandong Province during and after the COVID-19 pandemic, indicating the need for strengthening rapid identification of species and drug resistance among suspected TB patients to guide better medication and minimize the occurrence of drug resistance.
A prospective, multi-center study was conducted from April 2022 to June 2023. Pathogen and drug resistance were identified using nucleotide matrix-assisted laser desorption ionization time-of-flight mass spectrometry (nucleotide MALDI-TOF MS).
Of 940 suspected TB patients included in this study, 552 cases were found to be infected with MTB giving an overall positivity rate of 58.72%. Total of 346 cases were resistant to arbitrary anti-TB drug (62.68%), with Zibo (76.47%), Liaocheng and Weihai (both 69.23%) ranking top three and TB treatment history might be a related factor. Monoresistance was the most common pattern (33.53%), with isoniazid the highest at 12.43%, followed by rifampicin at 9.54%. Further analysis of gene mutations conferring resistance revealed diverse types with high heteroresistance rate found in multiple anti-TB drugs.
A relatively high rate of MTB positivity and drug resistance was found in Shandong Province during and after the COVID-19 pandemic, indicating the need for strengthening rapid identification of species and drug resistance among suspected TB patients to guide better medication and minimize the occurrence of drug resistance.
摘要：
■了解山东省疑似肺结核患者结核分枝杆菌(MTB)的阳性率和耐药特征,中国人口第二大省。
■预期，多中心研究于2022年4月至2023年6月进行.使用核苷酸基质辅助激光解吸电离飞行时间质谱（核苷酸MALDI-TOFMS）鉴定病原体和耐药性。
■在本研究中纳入的940名疑似结核病患者中，发现552例感染MTB，总阳性率为58.72％。对任意抗结核药物耐药346例(62.68%),淄博（76.47%），聊城和威海(均为69.23%)排名前三位，结核病治疗史可能是相关因素。单一抗性是最常见的模式(33.53%)，异烟肼最高，为12.43%，其次是利福平，占9.54%。对赋予耐药性的基因突变的进一步分析显示，在多种抗结核药物中发现了具有高异质耐药率的多种类型。
■在COVID-19大流行期间和之后，山东省发现了相对较高的MTB阳性率和耐药性，提示有必要加强对疑似结核病患者的物种和耐药性的快速识别，以指导更好的用药并最大程度地减少耐药性的发生。
■预期，多中心研究于2022年4月至2023年6月进行.使用核苷酸基质辅助激光解吸电离飞行时间质谱（核苷酸MALDI-TOFMS）鉴定病原体和耐药性。
■在本研究中纳入的940名疑似结核病患者中，发现552例感染MTB，总阳性率为58.72％。对任意抗结核药物耐药346例(62.68%),淄博（76.47%），聊城和威海(均为69.23%)排名前三位，结核病治疗史可能是相关因素。单一抗性是最常见的模式(33.53%)，异烟肼最高，为12.43%，其次是利福平，占9.54%。对赋予耐药性的基因突变的进一步分析显示，在多种抗结核药物中发现了具有高异质耐药率的多种类型。
■在COVID-19大流行期间和之后，山东省发现了相对较高的MTB阳性率和耐药性，提示有必要加强对疑似结核病患者的物种和耐药性的快速识别，以指导更好的用药并最大程度地减少耐药性的发生。
