Analysis on the influential factors of drug resistance and multidrug resistant tuberculosis in Wuhan City

Objective To investigate the influential factors of drug resistance or multidrug resistance of tuberculosis patients in Wuhan,and to provide scientific basis for municipal control strategy for drug resistance. Methods From December 2006 to June 2014,a total of 5 524 smear positive tuberculosis(TB) patients were screened for The Globel Fund to Tuberculosis project in Wuhan. Sputum samples were then smear cultured,identified and tested for drug susceptibility test (DST). DST results were statistically analyzed as patterns of drug resistance. The drug resistant rates of tuberculosis patients with different categories were described;χ² test and an unconditioned logistic regression were employed to carry out univariate as well as multivariate analysis on influential factors of drug resistant TB. Results The total drug resistance rate among these patients was 33.4% (1 627/4 870).There were decrease in total drug resistance and acquired drug resistance (all P<0.05). No upward trend was visible in terms of drug resistant rate of initial TB patients(χ_trend²=0.79,P=0.372). There were decrease in total multidrug-resistance,initial multidrug-resistance,and acquired multidrug-resistance (all P<0.05) in recent four years. The multivariate Logistic analysis results showed that the history of previous treatment for TB were more likely to have drug resistance(OR=2.212,95% CI:1.949-2.491,P<0.001) and multidrug-resistance(OR=3.433,95% CI:2.844-4.193,P<0.001) than primary treatment. Conclusions The epidemic of drug resistant and multidrug resistant Tuberculosis is falling. However to maintain the current downward trend, a strengthened effort must be put into the treatment and management of patients with a history of TB treatment.