The positivity rates and drug resistance patterns of Mycobacterium tuberculosis using nucleotide MALDI-TOF MS assay among suspected tuberculosis patients in Shandong, China: a multi-center prospective study

• Published in: Frontiers in public health 2024, Vol.12, p.1322426
• Main Authors: Gao, Xusheng, Li, Tongxia, Han, Wenge, Xiong, Yu, Xu, Shiyang, Ma, Hongbao, Wang, Qing, Zhang, Qiuxia, Yang, Guofeng, Xie, Dan, Jiang, Peipei, Wu, Hailiang, Lin, Mei, Liu, Min, Ni, Mingde, Wang, Decui, Li, Ying, Jiao, Lunxian, Ding, Caihong, Zhang, Zhongfa
• Format: Article
• Language: English
• Subjects: Antitubercular Agents - pharmacology; drug resistance; Humans; mutation; Mycobacterium tuberculosis - genetics; nucleotide MALDI-TOF MS; Nucleotides; Pandemics; Prospective Studies; Public Health; Shandong Province; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization - methods; tuberculosis; Tuberculosis - epidemiology
• ISSN: 2296-2565; 2296-2565
• DOI: 10.3389/fpubh.2024.1322426

To investigate the positivity rates and drug resistance characteristics of (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.