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Objective To evaluate the contribution of medical institutions in improving pulmonary tuberculosis(PTB) casefinding by analyzing the referral and diagnosis situation of PTB reported by medical institutions.Methods Thenumber of pulmonary tuberculosis cases and the number of tuberculosis patients diagnosed by the network of medical institutions in Chongqing from 2006 to 2015 were obtained by monthly report of tuberculosis control work and Tuberculosis Management Information System in Chongqing county districts,x2 test was used to analyze the reporting level and number of confirmed case with different year and different types of medical institutions.Results PTB or suspected PTB reported by medical institutions though network were 323 603 cases,which showed a upward trend year by year.The referral arrival rate was lower than national average level,and showed a downward trend in recent years.The proportion of confirmed PTB patients reported by medical institutions was found to increase year by year.Contribution rate of active PTB was increased from 10.14％ in 2006 to 52.09％ in 2015(x2 =25 610.75,P＜0.01),and contribution rate of smear positive PTB patients was increased from 6.42％ in 2006 to 52.46％ in 2015(x2 =10 520.65,P＜0.01).Contribution rate of multi-drug resistant PTB patients was 44.9％.Patients found by Municipal or County General Hospital was increased year by year(P＜0.01).The delay time of patients form medical institutions was 56 days,and the average delay rate patient was 79.62 ％.Conclusion The contribution of medical institutions to PTB case-finding is increasing,but the situation of delay is serious.
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Objective To evaluate the resistance of multidrug-resistant Mycobacterium tuberculosis ( M. tb) strains to bedaquiline ( BDQ) and to analyze the relationships between their genotypes and BDQ-re-sistant phenotypes in order to provide a scientific basis for rational use of BDQ for the treatment of multidrug-resistant tuberculosis ( MDR-TB) in clinical practice. Methods A total of 387 clinical M. tb strains, inclu-ding 100 pan-susceptible strains and 287 strains isolated from patients with MDR ( MDR-TB strains) , were enrolled in this study. Of the 287 MDR-TB strains, 77 strains were collected in Chongqing in 2015 and the other strains were collected in a national drug-resistant tuberculosis survey conducted in China during 2007 to 2008. Minimum inhibitory concentrations (MIC) of BDQ against those strains were detected. Genotypes of those strains were analyzed by Spoligotyping. Differences in the resistant rates against BDQ between Beijing genotype and non-Beijng genotype MDR-TB strains were comparatively analyzed. Results MIC50 and MIC90 of BDQ against the 287 MDR-TB strains were 0. 03 μg/ml and 0. 25 μg/ml, respectively. Nineteen out of the 287 MDR-TB strains (6. 6%) were resistant to BDQ. Based on the Spoligotyping, 195 strains were clas-sified into Beijing genotype, and the other 92 strains belonged to non-Beijing genotype. Statistical analysis revealed that the BDQ-resistant rate in Being genotype strains (4. 6%, 9/195) was lower than that in non-Beijing genotype strains (10. 9%, 10/92, χ2=3. 955, P=0. 047). In addition, the MIC50 and MIC90 of BDQ against pan-susceptible strains were 0. 03 μg/ml and 0. 12 μg/ml, respectively. Sixty-three pan-sus-ceptible strains belonged to Beijing genotype and the other 37 strains belonged to non-Beijing genotype. None of the pan-susceptible strains was resistant to BDQ. Conclusion This study indicates that BDQ showed stronger in vitro antibacterial activity against the MDR-TB strains isolated in China. A correlation between non-Beijing genotype and BDQ resistance is observed in those MDR strains. MDR strains of Beijing genotype are more susceptible to BDQ than those of non-Beijing genotype.
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Objective To investigate the epidemiological characteristics of tuberculosis (TB)in children in Chongqing and provide a data support for the establishment of children tuberculosis prevention and control strategy.Methods The TB data of chil-dren aged between 0 to 14 from 2009 to 2013 was analyzed.Results The average prevalence rates and registration rate of TB in children were 7.22/ 100 000 and 4.48/ 100 000,respectively.The cases mainly concentrated between10 to 14 years old.The epi-demic situation in southeast of chongqing was higher.And most of them were secondary tuberculosis of lung.The cases were mainly detected in referral,follow and clinical consultation.Conclusion The prevalence of TB in children of Chongqing was serious.It should take comprehensive measures to strengthen the prevention and control of children tuberculosis.
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Objective To know the vaccination status of BCG in Gaoxin district of Chongqing and explore the associated impact factors on seroconversion rate .Methods PPD was used to test the seroconversion status after PDG vaccination in infants under 3 months .Results There was no significant differences of seroconversion rate between different sex ,birth weight and vaccination age (P>0 .05) .But the rate was significantly higher in infants with normal birth weight than that in fetal macrosomia which was signif-icantly higher than that in low-birth weight .The rate was significantly decreased in infants of 1-2 months ,2-3 months and 0-1 months in order .The rate of infant with vaccination scar was significantly higher than that without scar (χ2 =80 .057 ,P<0 .01) . Conclusion There was no significant differences of seroconversion rate between different sex ,birth weight and vaccination age ,and the scar can indirectly show the seroconversion condition of vaccination .
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Objective To analyse and evaluate the status of drug-resistant tuberculosis of urban area of Chongqing ,and to pro-vide advice for the work of drug-resistant tuberculosis .Methods The smear positive TB cases registered between September 2009 and June 2010 were administered to questionnaire survey .At the same time ,the relating testing ,such as the sputum culture testing and drug susceptibility testing ,etc were conducted ,then analysis .Results The drug resistance rate and multi-drug resistant rate of smear positive TB cases of urban area were 27 .62% and 10 .50% respectively .The multi-drug resistant rate of new cases and re-treatment cases were 27 .62% and 23 .68% .The sequence of the rates of resistance were as follows :isoniazid(19 .34% ) ,streptomy-cin(18 .23% ) ,rifampicin(13 .26% ) ,ethambutol(11 .05% ) ,ofloxacin(6 .085% ) ,kanamycin(2 .21% ) .There were 20 types of drug-resistant spectrum among the 50 drug-resistant TB cases .The difference of the male gender and TB treatment and cough more than 2 weeks between the drug-resistant cases and the non drug-resistant cases were statistically significant (P<0 .05) .Conclusion The epidemic situation of drug-resistant tuberculosis of urban area is severe ,and the work of resistance monitoring should be routine . The correlative resistance factor should be concerned .