Factors influencing the recent transmission of multidrug-resistant tuberculosis in Hainan Province
- Author:
ZHONG Yeteng
;
WANG Jieying
;
CHEN Zhuolin
;
XU Yuni
;
QIU Wenhua
;
PEI Hua
- Publication Type:Journal Article
- Keywords:
Multidrug-resistant tuberculosis;
Mycobacterium tuberculosis;
risk factors;
recent transmission;
whole genome sequencing
- From:
China Tropical Medicine
2024;24(4):443-
- CountryChina
- Language:Chinese
-
Abstract:
Abstract: Objective To investigate the influencing factors related to the recent transmission of multidrug-resistant tuberculosis (MDR-TB) in Hainan Province, with the goal of providing an epidemiological basis for the region's prevention and control strategies, as well as clinical decision-making regarding MDR-TB. Methods Clinical respiratory specimens from MDR-TB patients treated at the Second Affiliated Hospital of Hainan Medical University from July 2019 to June 2021 were collected for mycobacterial isolation and cultivation. Isolates of multidrug-resistant Mycobacterium tuberculosis (MDR-MTB) identified through proportional drug-susceptibility screening were subjected to whole-genome sequencing (WGS). In conjunction with clinical and epidemiological data, factors influencing recent MDR-TB transmission were analyzed. Results A total of 202 MDR-TB patients were included in the study, primarily distributed across 18 cities and counties of Hainan Province (excluding Sansha City), and the patients were predominantly male. Phylogenetic analysis of the MDR-MTB strains showed that 56.4% (114/202) belonged to Lineage 2.2 (Beijing), 27.2% (55/202) to Lineage 2.1 (non-Beijing), 13.4% (27/202) to Lineage 4 (Euro-American), and 3.0% (6/202) to Lineage 1 (Indo-Oceanic). Through genetic distance analysis, 42 strains of MDR-MTB were found to be grouped into 15 clusters, with a clustering rate of 20.8%, indicating a significant level of recent transmission. Analysis of transmission-related factors revealed that non-agricultural occupations, initial treatment, and unmarried status were positively correlated with recent MDR-TB transmission, while older age and a history of smoking were negatively correlated. Notably, Lineage 2.2 (Beijing) showed a higher likelihood of MDR-TB transmission compared to Lineage 2.1 (non-eijing). Multivariate logistic regression analysis further identified that patients receiving initial treatment were an independent risk factor for recent MDR-TB transmission. Conclusions MDR-TB in Hainan Province exhibits distinctive genetic diversity, with Lineage 2.2 (Beijing) being the predominant epidemic strain. Recent transmission of MDR-TB in Hainan Province is associated with non-agricultural occupations, initial treatment, unmarried status, and Lineage 2.2 (Beijing), with the initial treatment being a likely independent risk factor for transmission. These findings offer vital clues for controlling MDR-TB and are expected to guide the formulation of targeted prevention and control strategies to reduce the transmission of the MDR-TB epidemic.
- Full text:202506161659596137215.Factors influencing the recent transmission of multidrug-resistant tuberculosis in Hainan Province.pdf
