Population-based surveillance of extensively drug-resistant tuberculosis in Shandong Province, China.

Correspondence to: Xin Ma, The Methodist Hospital Research Institute, 6565 Fannin Street, Houston, TX 77030, USA. Tel: (+1) 713 441 4326. Fax: (+1) 713 441 3599. e-mail: xma@tmhs.org; Haiying Wang, Shandong Provincial Chest Hospital, 46 Lishan Road, Jinan 250013, China. e-mail: liang19961111@126.com Article submitted 25 July 2011. Final version accepted 15 November 2011. To investigate the prevalence of extensively drug-resistant tuberculosis (XDR-TB) in Chinese populations, we analyzed the drug resistance profiles of 1787 Mycobacterium tuberculosis isolates through a population-based surveillance project in Shandong Province, China. We found 330 (18.5%; 95%CI 16.1–20.3) isolates resistant to ⩾1 first-line drug and 65 (3.6%; 95%CI 2.9–4.6) multidrug-resistant (MDR) isolates, of which 13 (20.0%; 95%CI 11.9–31.4) were XDR; 47/65 MDR-TB isolates (70.8%; 95%CI 58.2–81.4) were resistant to fluoroquinolones. Our results indicate that inadequate application of second-line anti-tuberculosis drugs has caused increased prevalence of XDR-TB in certain Chinese populations. K E Y W O R D S : Mycobacterium tuberculosis; extensively drug-resistant tuberculosis; multidrug-resistant tuberculosis