Characteristics and risk factors of drug‐resistant tuberculosis in Sichuan, China: An observational study

• DOI: 10.1111/tmi.14126
• Publication Date: 2025-05-15T09:32:51Z
• Authors: Ning Han; Libo Yan; Man Yuan; Zhu Chen; Yilan Zeng; Hong Tang

AbstractObjectivesThis study aimed to determine the epidemiological characteristics of drug‐resistant tuberculosis (DR‐TB) and investigate the risk factors associated with multidrug‐resistant tuberculosis (MDR‐TB) in Sichuan, China.MethodsThe study involved 5180 clinical isolates collected from Sichuan since 2013, with non‐tuberculous mycobacteria excluded. Drug susceptibility testing was conducted using four first‐line anti‐TB drugs, fluoroquinolones, and second‐line injectable agents. Multivariable logistic regression analysis was used to assess risk factors for MDR‐TB based on patients' treatment history, age, sex, ethnicity, health facility, living environment and human immunodeficiency virus (HIV) status.ResultsAmong the 5180 participants, resistance was highest for isoniazid (23.59%), followed by rifampin (18.42%), streptomycin (18.42%) and ethambutol (2.47%). The prevalence of MDR‐TB was 774 (14.94%) among all cases, with 575 (14.20%) in newly diagnosed tuberculosis (TB) patients and 199 (17.60%) in previously treated patients. Additionally, 17 (0.33%) patients were diagnosed with MDR‐TB. Furthermore, urban living was identified as a protective factor against MDR‐TB (odds ratio [OR] 0.80, 95% confidence interval [CI] 0.68–0.94, p = 0.004). Notably, individuals younger than 60 were more likely to develop MDR‐TB, especially those aged 32–45 (OR 2.22, 95% CI 1.74–2.83, p < 0.001). In addition, HIV‐positive status was identified as a risk factor for MDR‐TB (OR 2.06, 95% CI 1.21–3.49, p = 0.008).ConclusionsThe study demonstrated that the prevalence of DR‐TB among the study subjects exceeded the national level. Patients living in rural areas, those with a history of TB treatment, HIV‐positive individuals, and younger patients were more likely to develop MDR‐TB.