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Objective To analyze the drug resistance features of 118 patients with bone and joint tuberculosis. Methods The clinical data of 118 joint tuberculosis patients who were hospitalized in Beijing Chest Hospital from January 2016 to January 2022 were retrospectively analyzed. Drug susceptibility test was performed for the following 16 drugs streptomycin (Sm), isoniazid (INH), rifampicin (RFP), ethambutol (EMB), rifapentine (Rft), levofloxacin (Lfx), amikacin (Am), capreomycin (Cm), prothionamide (Pto), isoniazid aminosalicylate (Pa), moxifloxacin (Mfx), p-aminosalicylic acid (PAS), clarithromycin (Clr), rifabutin (Rfb), kanamycin (Km) and clofazimine (Cfz). Analyze the Mycobacterium tuberculosis culture results, drug sensitivity results, initial or retreatment status of patients with bone and joint tuberculosis, as well as the drug resistance types of patients diagnosed with bone and joint tuberculosis by etiology. Results The total drug resistance rate of 118 bone and joint tuberculosis patients to at least one of the 16 drugs was 28.0%(33/118), of which the drug resistance rate was significantly higher in previously treated patients than in new patients with statistically significant difference [70.0%(21/30) vs. 13.6%(12/88), P<0.001]. The top seven drug resistance rate of bone and joint tuberculosis to the 16 drugs were: Sm, INH, RFP, Rft, Rfb, Pa and Clr, and the top seven drug resistance rates of new patients were: Sm, INH, Clr, Pa, RFP, Rft and PAS, and the top seven drug resistance rates of in previously treated patients were: Sm, RFP, Rft, Rfb, INH, Pa and EMB. The mono-resistance rate of bone and joint tuberculosis, poly-drug resistance rate of spinal tuberculosis, and multidrug-resistance rate were 7.6%(9/118), 8.5%(10/118), and 11.9%(14/118), respectively. There was no significant difference of the mono-resistance rate of bone and joint tuberculosis between new patients and in previously treated patients [6.8%(6/88) vs. 10.0%(3/30), P=0.691], but the poly-drug resistance rate and the multidrug-resistance rate were significantly higher in previously treated patients than in new patients, and the differences were statistically significant [20.0%(6/30) vs. 4.5%(4/88), P=0.017; 40.0%(12/30) vs. 2.3%(2/88), P<0.001]. Conclusions There was serious epidemic of drug resistance in bone and joint tuberculosis. While performing surgical treatment, clinicians should develop effective drug treatment regimens according to the results of drug sensitivity tests.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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