To study the rifampicin resistance, genotypic characteristics and clustering of Mycobacterium tuberculosis in Ningxia from 2020-2023.

98 strains of Mycobacterium tuberculosis were tested for rifampicin resistance using the GeneXpert MTB/RIF method, and the strains were genotyped by the McSpoligotyping method and analyzed by clustering at the MIRU-VNTRplus website.

The risk of developing rifampicin-resistant TB was significantly increased in retreatment patients (OR=33.22, 95% CI: 3.11-355.43, P<0.05), and TB patients from Zhongwei and Wuzhong cities showed a higher risk of rifampicin resistance (OR=19.42, 95% CI: 1.12-336.75, P<0.05; OR=43.25, 95% CI: 1.76-1062.70, P<0.05). 98 strains of Mycobacterium tuberculosis were typed by McSpoligotyping to present three lineages, with the largest lineage being the Beijing-type 80 strains (81.63%); the non-Beijing-type accounted for 18 strains (18.37%), of which 12 strains were of the T-type (12.24%), 1 strain of the U-type (1.02%), and the newly 5 strains (5.10%) were newly discovered or undefined genotypes. The Beijing type was widely distributed in all cities of Ningxia, with only the Beijing type in Guyuan and Shizuishan, and the T-type and newly discovered or undefined genotypes were mostly found in Zhongwei, Wuzhong and Yinchuan. Cluster analysis showed that the 98 strains were divided into two genetic clusters, Beijing-type and non-Beijing-type, with SIT1 accounting for the largest proportion of Beijing-type in the clusters (75.51%), T1-type in the non-Beijing-type, and the remaining 9 strains (9.18%) were independent scattered genotypes, with a cluster rate of 90.82% (89/98).

Health education has been actively carried out for retreatment patients and high-risk areas in the Ningxia region to improve treatment adherence, and TB screening and drug resistance surveillance has been strengthened in Zhongwei and Wuzhong cities. In addition, Mycobacterium tuberculosis is genetically polymorphic in this region, and Beijing SIT 1 is the main prevalent strain. Strengthening the monitoring of this gene and understanding its mode of transmission is important for controlling the spread of tuberculosis, slowing down the development of drug resistance, and ultimately improving the public health situation in the region.