Transmission of multidrug-resistant tuberculosis in Jiangxi, China, and associated risk factors

• Published in: Microbiology spectrum 2024-11, Vol.12 (11), p.e0355523
• Main Authors: Zhan, Jiahuan, Wang, Wei, Luo, Dong, Chen, Qiang, Yu, Shengming, Yan, Liang, Chen, Kaisen
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antitubercular Agents - pharmacology; China - epidemiology; Drug Resistance, Multiple, Bacterial - genetics; Epidemiology; Female; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Moxifloxacin - pharmacology; Moxifloxacin - therapeutic use; multidrug-resistant tuberculosis; Mycobacterium tuberculosis - drug effects; Mycobacterium tuberculosis - genetics; Research Article; Retrospective Studies; risk factor; Risk Factors; transmission; Tuberculosis, Multidrug-Resistant - epidemiology; Tuberculosis, Multidrug-Resistant - microbiology; Tuberculosis, Multidrug-Resistant - transmission; Whole Genome Sequencing; Young Adult
• ISSN: 2165-0497; 2165-0497
• DOI: 10.1128/spectrum.03555-23

In order to effectively combat the urgent threat of multidrug-resistant tuberculosis (MDR-TB), it is imperative to gain a comprehensive understanding of the drug-resistant profiles, transmission dynamics, and associated risk factors. Our study encompassed a population-based retrospective analysis with 130 MDR-TB patients from 2018 to 2021. The research methodology incorporated whole-genome sequencing, drug susceptibility testing , and logistic regression analysis to discern the risk factors of genomic clustering linked to recent transmission. The findings from phenotypic drug resistance assessments revealed notable resistance rates: ethambutol at 62.3% (81/130), streptomycin at 72.3% (94/130), levofloxacin at 51.5% (67/130), and moxifloxacin at 50.0% (65/130). Furthermore, among all patients, 38 individuals (29.23%, 38/130) were found to be part of 17 clusters, indicating instances of recent MDR-TB transmission. The genomic clustering patients were deeply investigated. Lineage 2.2.1 was established as the primary sub-lineage (86.15%, 112/130), followed by lineage 4 (9.23%, 12/130). Moreover, the logistic regression analysis underscored that unemployment, farming occupations, and prior TB treatment were identified as significant risk factors for recent transmission. The high prevalence of multidrug-resistant tuberculosis (MDR-TB) in Jiangxi Province highlights the importance of understanding the genetic background and drug resistance patterns of these strains. This knowledge is crucial for developing effective control methods. Furthermore, in light of the significance of preventing transmission among tuberculosis patients, whole-genome sequencing was utilized to investigate the recent transmission of MDR-TB and identify associated risk factors. The findings revealed that individuals in the farming sector, those who are unemployed, and patients with a history of tuberculosis treatment are at elevated risk. Consequently, targeted public interventions for these at-risk groups are imperative.