Analysis Of The Epidemic Characteristics And Inflience Factors Of Multi Drug Resistant Tuberculosis In Urumqi

Objectives: Surveyed,biological specimen collected and laboratory tested based on multi drug resistant tuberculosis patients in Urumqi to understand MDR-TB epidemic situation,epidemic characteristics and factors,provide a theoretical basis for the prevention and control of multi drug resistant tuberculosis.Methods: This study used epidemiological research method of prevalence survey.The object of this research was above 16 years TB culture positive patient who diagnosed and registered by Urumqi CDC in the period from 2014.1.1-2015.6.30.Epidemiological survey,sputum smear detection test,MTB isolation identification test,drug susceptibility test of MTB,linear probe technology and multilocus tandem repeat typing technique(MIRU-VNTR)all this method used to understand the prevalence and epidemic characteristics of MDR-TB.Non conditional Logistic regression model and multi factor dimensionality reduction model(MDR)used to discussed the influence factors,interaction of genes and factors of MDR-TB in Urumqi.Results: 1.The total MDR-TB rate of Urumqi was 5.956%,the initial treatment MDR-TB rate of Urumqi was 3.957%,the retreatment MDR-TB rate of Urumqi was 19.512%.2.(1)Characteristics of population distribution in MDR-TB rate was high in low and high age group,man group,Uygur group,farmer group,degree of high school education group,unmarried group and local population group.(2)Characteristics of time distribution in MDR-TB rate was high in spring and autumn.Characteristics of bacteriological distribution in MDR-TB rate was high in smear positive,strains of MTB.Resistant combination in MDR-TB percentage was most high in INH+RFP and INH+RFP+SM+Ofx.(3)Characteristics of distribution in drug-resistant gene mutation in of molecular biological was that 315 locus of kat G was mutation in isoniazid,526 and 531 locus of ropB was mutation in rifampin,206 locus of emb B was mutation in ethylamine,43 locus of rpsL and 1401 locus of rrs was mutation in streptomycin,74,90,91 and 94 locus of gyr A was mutation in ofloxacin.Genotype of 158 MTB in 319 MTB is Beijing type(it is 49.530%in all MTB),and 14 strains is Multi drug resistant strains(it is 73.684%in all Multi drug resistant strains).Multi drug resistant rate of Beijing genotype is 8.861%.MDR-TB cluster rate was 5.263%in Urumqi.3.Single factor analysis showed that four factors of MDR-TB was diagnosis delay,type of treatment,history of anti tuberculosis and history of work(P<0.05).Non conditional Logistic regression analysis showed that risk factors of MDR-TB was history of work(yes/no: OR=10.000;95%CI: 2.068-48.359),diagnosis delay(yes/no: OR=7.178;95%CI: 1.915-26.905)and history of anti tuberculosis(yes/no: OR=15.568;95%CI: 4.711-51.093)in Urumqi.Analysis showed that the Beijing genotype and work history,past history of anti tuberculosis treatment delay,there was a positive interaction between(synergy or enhancement).Conclusion: The retreatment of MDR-TB was serious in Urumqi.Molecular biology techniques and DNA fingerprint technology et al modern molecular epidemiological methoded should be used to improve the diagnosis rate and medical records tracking and investigation of the source on infection.We should strengthen publicity and screening to patients who history of work,diagnosis delay and history of anti tuberculosis for early discovery,early diagnosis,early treatment.In order to end the popular purpose of MDR-TB in Urumqi city.