Prevalence and patterns of drug-resistant Mycobacterium tuberculosis in newly diagnosed patients in China: A systematic review and meta-analysis

• Published in: Journal of global antimicrobial resistance. 2024-09, Vol.38, p.292-301
• Main Authors: Jin, Cong, Wu, Yuting, Chen, Jiangpo, Liu, Jing, Zhang, Hongwei, Qian, Qingzeng, Pang, Tieliang
• Format: Article
• Language: English
• Subjects: Ethambutol; Isoniazid; Multi-drug resistance; Mycobacterium tuberculosis; Rifampicin; Streptomycin; Tuberculosis
• ISSN: 2213-7165; 2213-7173; 2213-7173
• DOI: 10.1016/j.jgar.2024.05.018

•This study analysed mono- and multi-drug resistance using 87,667 newly diagnosed TB cases across China.•Prevalence rates for resistance to INH, RIF, EMB, SM, along with MDR and XDR TB in China were found to be 18.2%, 10.5%, 5.7%, 17.1%, 6.9%, and 0.9%, respectively.•Despite efforts, the prevalence rates of MDR- and XDR-TB remain alarmingly high. Tuberculosis (TB), one of the deadliest infectious diseases globally, is increasingly exacerbated in China by the emergence of resistant Mycobacterium tuberculosis (MTB) strains. Drug-resistant TB, including mono-drug-resistant TB, multidrug-resistant TB (MDR-TB), and extensively drug-resistant TB (XDR-TB), presents significant public health challenges. We conducted a systematic literature review from January 2010 to February 2024 using databases such as PubMed, Embase, Web of Science, and Google Scholar. Our focus was on empirical data related to drug resistance patterns in newly diagnosed TB cases. Non-empirical studies were excluded through meticulous filtering. For the meta-analysis, we used Review Manager (RevMan) 5.2 and assessed evidence quality using the Newcastle-Ottawa Scale (NOS). Our search strategy identified 40 studies that met the inclusion criteria, encompassing a total sample size of 87,667 participants. Among new TB cases, the estimated prevalence of MDR-TB in China was 6.9% (95% CI: 5.6–8.1%). Prevalence rates for mono-drug resistance to first-line anti-TB medications were as follows: isoniazid at 18.2% (95% CI: 16.4–20.6%), rifampicin at 10.5% (95% CI: 8.6–12.8%), and ethambutol at 5.7% (95% CI: 4.1–7.3%). The prevalence of streptomycin resistance, a former first-line anti-TB drug, was 17.1% (95% CI: 14.6–19.1%). The prevalence of other types of mono-drug resistance was 15.2% (95% CI: 13.9–17.3%), and for XDR-TB, it was 0.9% (95% CI: 0.6–1.4%). The high prevalence of drug-resistant TB in China poses a significant public health challenge. There is an urgent need for targeted interventions and continued surveillance to combat the spread of drug-resistant TB.