Transmission of MDR and XDR tuberculosis in Shanghai, China

Ming Zhao, Xia Li, Peng Xu, Xin Shen, Xiaohong Gui, Lili Wang, Kathryn DeRiemer, Jian Mei, Qian Gao

Research output: Contribution to journalArticle

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Abstract

Background: Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) are global health problems. We sought to determine the characteristics, prevalence, and relative frequency of transmission of MDR and XDR TB in Shanghai, one of the largest cities in Asia. Methods: TB is diagnosed in district TB hospitals in Shanghai, China. Drug susceptibility testing for first-line drugs was performed for all culture positive TB cases, and tests for second-line drugs were performed for MDR cases. VNTR-7 and VNTR- 16 were used to genotype the strains, and prior treatment history and treatment outcomes were determined for each patient. Results: There were 4,379 culture positive TB cases diagnosed with drug susceptibility test results available during March 2004 through November 2007. 247 (5.6%) were infected with a MDR strain of M. tuberculosis and 11 (6.3%) of the 175 MDR patients whose isolate was tested for susceptibility to second-line drugs, were XDR. More than half of the patients with MDR and XDR were newly diagnosed and had no prior history of TB treatment. Nearly 57% of the patients with MDR were successfully treated. Discussion: Transmission of MDR and XDR strains is a serious problem in Shanghai. While a history of prior anti-TB treatment indicates which individuals may have acquired MDR or XDR TB, it does not accurately predict which TB patients have disease caused by transmission of MDR and XDR strains. Therefore, universal drug susceptibility testing is recommended for new and retreatment TB cases.

Original languageEnglish (US)
Article numbere4370
JournalPLoS One
Volume4
Issue number2
DOIs
StatePublished - 2009

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Multidrug-Resistant Tuberculosis
tuberculosis
China
Tuberculosis
Pharmaceutical Preparations
drugs
minisatellite repeats
Extensively Drug-Resistant Tuberculosis
Chronic Disease Hospitals
Testing
Medical problems
Retreatment
District Hospitals
testing
Therapeutics
History
Genotype

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Zhao, M., Li, X., Xu, P., Shen, X., Gui, X., Wang, L., ... Gao, Q. (2009). Transmission of MDR and XDR tuberculosis in Shanghai, China. PLoS One, 4(2), [e4370]. https://doi.org/10.1371/journal.pone.0004370

Transmission of MDR and XDR tuberculosis in Shanghai, China. / Zhao, Ming; Li, Xia; Xu, Peng; Shen, Xin; Gui, Xiaohong; Wang, Lili; DeRiemer, Kathryn; Mei, Jian; Gao, Qian.

In: PLoS One, Vol. 4, No. 2, e4370, 2009.

Research output: Contribution to journalArticle

Zhao, M, Li, X, Xu, P, Shen, X, Gui, X, Wang, L, DeRiemer, K, Mei, J & Gao, Q 2009, 'Transmission of MDR and XDR tuberculosis in Shanghai, China', PLoS One, vol. 4, no. 2, e4370. https://doi.org/10.1371/journal.pone.0004370
Zhao, Ming ; Li, Xia ; Xu, Peng ; Shen, Xin ; Gui, Xiaohong ; Wang, Lili ; DeRiemer, Kathryn ; Mei, Jian ; Gao, Qian. / Transmission of MDR and XDR tuberculosis in Shanghai, China. In: PLoS One. 2009 ; Vol. 4, No. 2.
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abstract = "Background: Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) are global health problems. We sought to determine the characteristics, prevalence, and relative frequency of transmission of MDR and XDR TB in Shanghai, one of the largest cities in Asia. Methods: TB is diagnosed in district TB hospitals in Shanghai, China. Drug susceptibility testing for first-line drugs was performed for all culture positive TB cases, and tests for second-line drugs were performed for MDR cases. VNTR-7 and VNTR- 16 were used to genotype the strains, and prior treatment history and treatment outcomes were determined for each patient. Results: There were 4,379 culture positive TB cases diagnosed with drug susceptibility test results available during March 2004 through November 2007. 247 (5.6{\%}) were infected with a MDR strain of M. tuberculosis and 11 (6.3{\%}) of the 175 MDR patients whose isolate was tested for susceptibility to second-line drugs, were XDR. More than half of the patients with MDR and XDR were newly diagnosed and had no prior history of TB treatment. Nearly 57{\%} of the patients with MDR were successfully treated. Discussion: Transmission of MDR and XDR strains is a serious problem in Shanghai. While a history of prior anti-TB treatment indicates which individuals may have acquired MDR or XDR TB, it does not accurately predict which TB patients have disease caused by transmission of MDR and XDR strains. Therefore, universal drug susceptibility testing is recommended for new and retreatment TB cases.",
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