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Comparative Study
. 2024 Aug 9;24(1):807.
doi: 10.1186/s12879-024-09712-3.

Drug resistance in drug-resistant tuberculosis patients with and without diabetes mellitus: a comparative analysis

Xiaoxiao Cai  1 , Xueqin Xu  2 , Guiqing He  3   4 , Xiangao Jiang  5   6 , Lianpeng Wu  7   8
Affiliations
Comparative Study

Drug resistance in drug-resistant tuberculosis patients with and without diabetes mellitus: a comparative analysis

Xiaoxiao Cai et al. BMC Infect Dis. .

Abstract

Background: This dual burden of tuberculosis (TB) and diabetes mellitus (DM) has become a global public health concern. This study aims to compare drug resistance in drug-resistant tuberculosis (DR-TB) patients with and without DM and analyse the risk factors of multidrug-resistant tuberculosis (MDR-TB).

Methods: A total of 893 DR-TB patients were admitted to Wenzhou Central Hospital between January 2018 and December 2022. After excluding 178 cases with incomplete clinical and laboratory data, 715 patients were included in the study. These patients were then categorized into two groups based on the presence of type 2 DM: the DM group (160 cases) and the non-DM group (555 cases). Demographic information, baseline clinical characteristics, laboratory and imaging test results, clinical diagnoses, and other relevant data were collected for analysis. Statistical analysis was conducted on demographic information, clinical parameters, drug resistance spectrum, and risk factors for multidrug resistance.

Results: In both the DM and non-DM groups, the order of resistance to first-line anti-tuberculosis drugs is isoniazid, streptomycin, rifampicin, and ethambutol. There is no significant difference in the proportion of mono-resistant tuberculosis, polydrug-resistant tuberculosis, and multidrug-resistant tuberculosis between the two groups (P > 0.05). The prevalence of MDR-TB in both groups shows a downward trend between 2018 and 2022, but the trend is not statistically significant (P > 0.05). Among patients without DM, residence in rural areas, retreatment of tuberculosis, pulmonary cavity, and uric acid ≥ 346 µmol/L are identified as independent risk factors for MDR-TB. Among patients with DM, residence in rural areas, retreatment of tuberculosis, pulmonary cavity, and HbA1c ≥ 9.8% were identified as independent risk factors for MDR-TB.

Conclusion: Isoniazid is the most resistant drug among DR-TB patients with and without DM. There is no statistically significant difference in drug resistance patterns between the two groups. Some progress has been made in the prevention and control of DR-TB in this area, but the effect is not very significant. There are differences in the risk factors of MDR-TB between patients with and without DM.

Keywords: Diabetes mellitus; Drug resistance profile; Drug-resistant tuberculosis; Multidrug-resistant tuberculosis; Risk factors.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the patients enrolled in the study. Abbreviation: DM, diabetes mellitus
Fig. 2
Fig. 2
Proportion of DR-TB with and without DM patients in different age groups. Abbreviation: DM, diabetes mellitus
Fig. 3
Fig. 3
Trends in the proportion of MDR among DR-TB patients without and with DM from 2018 to 2022. Abbreviation: DM, diabetes mellitus
See this image and copyright information in PMC

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