Drug Resistance And Genotype Analysis Of Mycobacterium Tuberculosis In Border And Non-border Areas Of Guangxi

Objective The purpose of this study is to investigate and compare the drug resistance and genotypes of Mycobacterium tuberculosis(MTB)from 2016 to2017 in border and non-border areas of Guangxi,to understand the differences in drug resistance and genotypes of MTB between the two regions,and to provide references for tuberculosis(TB)control and targeted prevention measures.Methods Baise,Chongzuo and Fangchenggang were used as border monitoring points(border group),and Guilin and Guigang were used as non-border monitoring points(non-border groups).From 2016 to 2017,TB patients who met the criteria for monitoring case inclusion were continuously included in the study from the TB control agency.The patient's questionnaire information and MTB were collected,and the drug resistance test was performed on MTB,and genotyping was performed using melting curve analysis-based spoligotyping(McSpoligotyping)technique.Finally,the data was entered into the Epidata 3.0 database and statistical analysis was performed using SPSS 17.0.Results 1.Comparison of MTB resistance status and influencing factors between Guangxi border area and non-border area: A total of 1306 patients with TB who met the definition of the case were included,including 631 in the border group and 675 in the non-border group.Comparing the distribution of patients in the border group and the non-border group,the results showed that the distribution of national and family per capita annual income,cultural level and patient type was statistically significant(P<0.05).The border group and non-border group were mainly Zhuang and Han.In the border group,the proportion of patients with a per capita annual income of ? 4,000 yuan,a cultural level below the high school and re-treatment is higher than that of the non-border group.A total of 6 drugs,INH,RFP,EMB,SM,Ofx,and Km,were detected in this study.The total drug resistance rate,mono-drug resistant(MR)rate,poly-drug resistant(PDR)rate,and multiple drug resistant(MDR)rate of the border group(18.07%,9.51%,2.69%,and 5.86%)were higher than the non-border group(11.11%,7.70%,1.78%,and 1.63%,).There was a statistically significant difference in the total drug resistance rate and MDR rate between the two groups(P<0.05).The resistance rate of the six tested drugs in the border group was higher than that in the non-border group,and the difference of INH and RFP between the two groups was statistically significant(P<0.05).Univariate and multivariate logistic regression analysis showed that the factors affecting drug resistance in both border and non-border groups were patient types,and retreatment was a risk factor for drug resistance in TB patients in two groups,the OR value was 1.86(95% CI: 1.13?3.05)in the border group and2.72(95% CI: 1.39?5.33)in the non-border group.2.Comparison of MTB genotypes between Guangxi border area and non-border area: A total of 450 MTBs were respectively randomly selected fromthe border group and the non-border group for McSpoligotyping test.A total of881 MTB genotyping results were obtained,including 435 border group and 446non-border group.The results of Spoligotyping showed that both MTB could be divided into Beijing genotype and non-Beijing genotype,and the proportion of Beijing-type MTB in non-border group was higher than that in border group(65.25% vs 55.63%,P<0.05).Among the non-Beijing strains,the border group can be further divided into T,H,EAI,LAM and MANU(the proportions are:22.76%,3.45%,1.84%,0.46% and 0.23%),The non-border group can be further divided into T,H and EAI(the proportions are: 19.51%,3.58% and 0.22%),and the distribution difference of EAI between the two groups is statistically significant(P<0.05).The results of genotypic cluster analysis showed that the clustering rate of MTB gene in non-border group was higher than that in border group(80.04% vs 73.33%),the difference was statistically significant(P<0.05).The correlation between Beijing genotype and MTB resistance was analyzed.The results showed that the total resistance rate of Beijing genotype MTB in non-border group was higher than that of non-Beijing genotype MTB(P<0.05).There was no significant difference in the distribution of drug resistance between the Beijing genotype and the non-Beijing genotype in the border group(P>0.05).Conclusion The proportion of TB patients with low economic and cultural level and re-treatment in Guangxi border area is higher than that of non-border area.The drug-resistant tuberculosis(DR-TB),especially the multi-drug resistant tuberculosis(MDR-TB)epidemic is more serious than the non-border area,and should be paid attention to,and retreatment is a risk factor for drug resistance in TB patients in the two places;Beijing genotype MTB is the main epidemic strain in both border area and non-border area,but the proportion ofBeijing genotypes in non-border area is higher than that in border area;The proportion of EAI MTB in the border area is higher than that in non-border area;The clustering rate of MTB genes in non-border area is higher than that in border area;There is no correlation between MTB genotype and drug resistance in border area;The total resistance rate of Beijing genotype MTB in non-border group was higher than that of non-Beijing genotype MTB.