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Abstract：
BACKGROUND: Tuberculosis (TB) remains a global public health event of great concern, however epidemic data on TB covering entire areas during the special period of the COVID-19 epidemic have rarely been reported. We compared the dissemination and multidrug-resistance patterns of Mycobacterium tuberculosis complex (MTBC) in the main urban area of Luoyang City, China (including six municipal jurisdictions) and nine county and township areas under its jurisdiction, aimed to establish the epidemiology of TB in this region and to provide reference for precision anti-TB in places with similar settings.
METHODS: From 2020 to 2022, sputum samples were collected from 18,504 patients with confirmed, suspected and unexcluded TB in 10 designated TB medical institutions. Insertion sequence 6110 was amplified by PCR (rpoB gene detection if necessary) to confirm the presence of MTBC. PCR-positive specimens were analyzed by multicolor melting curve analysis to detect multidrug resistance.
RESULTS: Among the 18,504 specimens, 2675 (14.5%) were MTBC positive. The positive rate was higher in the main urban area than in the county and township areas (29.8% vs. 10.9%, p < 0.001). Male, re-treated and smear-positive groups were high-burden carriers of MTBC. Individuals aged > 60 years were the largest group infected with MTBC in the main urban area, compared with individuals aged < 61 years in the county and township areas. The detection of multidrug-resistant TB (MDR-TB) was higher in the main urban area than in the county and township areas (13.9% vs. 7.8%, p < 0.001). In all areas, MDR-TB groups were dominated by males, patients with a history of TB treatment, and patients aged < 61 years. Stratified analysis of MDR-TB epidemiology showed that MDR4 (INH þ RIF þ EMB þ SM) was predominant in the main urban area, while MDR3 (INH þ RIF þ SM) was predominant in the county and township areas. MDR-TB detection rate and epidemiology differed among the county and township areas.
CONCLUSIONS: For local TB control, it is necessary to plan more appropriate and accurate prevention and control strategies according to the regional distribution of MTBC infection.
METHODS: From 2020 to 2022, sputum samples were collected from 18,504 patients with confirmed, suspected and unexcluded TB in 10 designated TB medical institutions. Insertion sequence 6110 was amplified by PCR (rpoB gene detection if necessary) to confirm the presence of MTBC. PCR-positive specimens were analyzed by multicolor melting curve analysis to detect multidrug resistance.
RESULTS: Among the 18,504 specimens, 2675 (14.5%) were MTBC positive. The positive rate was higher in the main urban area than in the county and township areas (29.8% vs. 10.9%, p < 0.001). Male, re-treated and smear-positive groups were high-burden carriers of MTBC. Individuals aged > 60 years were the largest group infected with MTBC in the main urban area, compared with individuals aged < 61 years in the county and township areas. The detection of multidrug-resistant TB (MDR-TB) was higher in the main urban area than in the county and township areas (13.9% vs. 7.8%, p < 0.001). In all areas, MDR-TB groups were dominated by males, patients with a history of TB treatment, and patients aged < 61 years. Stratified analysis of MDR-TB epidemiology showed that MDR4 (INH þ RIF þ EMB þ SM) was predominant in the main urban area, while MDR3 (INH þ RIF þ SM) was predominant in the county and township areas. MDR-TB detection rate and epidemiology differed among the county and township areas.
CONCLUSIONS: For local TB control, it is necessary to plan more appropriate and accurate prevention and control strategies according to the regional distribution of MTBC infection.
摘要：
背景：结核病（TB）仍然是一个备受关注的全球公共卫生事件，然而，在COVID-19流行的特殊时期，覆盖整个地区的结核病的流行数据很少报告。我们比较了洛阳市主城区结核分枝杆菌（MTBC）的传播和多药耐药模式，中国(含6个市辖区)和9个县乡辖区,旨在建立该地区结核病的流行病学，为类似场所的精准抗结核提供参考。
方法：从2020年到2022年，收集了18,504例确诊患者的痰标本，10个指定结核病医疗机构的疑似和未排除结核病。通过PCR(如果需要,rpoB基因检测)扩增插入序列6110以确认MTBC的存在。通过多色熔解曲线分析分析PCR阳性标本以检测多药耐药性。
结果：在18,504个样本中，2675（14.5%）为MTBC阳性。主城区的阳性率高于县乡地区(29.8%vs.10.9%,p<0.001)。男性,再治疗和涂片阳性组是MTBC的高负荷携带者。>60岁的个体是主城区感染MTBC的最大群体,与县乡地区年龄<61岁的个人相比。主城区耐多药结核病(MDR-TB)检出率高于县乡(13.9%vs.7.8%,p<0.001)。在所有领域,耐多药结核病组以男性为主，有结核病治疗史的患者，患者年龄<61岁。对MDR-TB流行病学的分层分析表明，MDR4（INH_RIF_EMB_SM）在主要城市地区占主导地位，而MDR3(INH·RIF·SM)在县和乡镇地区占主导地位。县和乡镇地区的耐多药结核病检出率和流行病学有所不同。
结论：对于本地结核病控制，有必要根据MTBC感染的区域分布制定更恰当、准确的防控策略。
方法：从2020年到2022年，收集了18,504例确诊患者的痰标本，10个指定结核病医疗机构的疑似和未排除结核病。通过PCR(如果需要,rpoB基因检测)扩增插入序列6110以确认MTBC的存在。通过多色熔解曲线分析分析PCR阳性标本以检测多药耐药性。
结果：在18,504个样本中，2675（14.5%）为MTBC阳性。主城区的阳性率高于县乡地区(29.8%vs.10.9%,p<0.001)。男性,再治疗和涂片阳性组是MTBC的高负荷携带者。>60岁的个体是主城区感染MTBC的最大群体,与县乡地区年龄<61岁的个人相比。主城区耐多药结核病(MDR-TB)检出率高于县乡(13.9%vs.7.8%,p<0.001)。在所有领域,耐多药结核病组以男性为主，有结核病治疗史的患者，患者年龄<61岁。对MDR-TB流行病学的分层分析表明，MDR4（INH_RIF_EMB_SM）在主要城市地区占主导地位，而MDR3(INH·RIF·SM)在县和乡镇地区占主导地位。县和乡镇地区的耐多药结核病检出率和流行病学有所不同。
结论：对于本地结核病控制，有必要根据MTBC感染的区域分布制定更恰当、准确的防控策略。
