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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.