The available data on the epidemic of drug resistant tuberculosis (TB) among children in China is limited.This study attempted to clarify the drug resistance profiles of clinical strains isolated from children andestimate risk factors related to acquisition of drug resistance. AllMycobacterium tuberculosisstrains fromchildren (age<15 years) and adolescent (age 15e18 years) TB patients received in the strain library ofChinese Center for Disease Control and Prevention between January 2005 and December 2012 wereincluded in the study. A study collection included 450 clinical isolates (100 from children, 159 fromadolescents, and 191 from adults) from all over China. Drug susceptibility testing was performed by aproportion method. As a result, the drug resistance and multi-drug resistance (MDR) rates in childrenwere 55% (55/100) and 22% (22/100), respectively. In children with MDR-TB, new cases accounted for40.9% (9/22). Compared with adults, the drug resistance rates were similar in all subgroups (new cases,previously treated cases and all cases) of children (P>0.05), except for the lower resistance rate toisoniazid in total cases of children (P ¼0.011). Patient related information was included in the MDR-TBassociation analysis. The treatment history was found to be strongly associated with MDR-TB in all threeage groups (P<0.05). Our results demonstrate that the prevalence of drug resistant TB in children inChina is alarmingly high and similar to that seen in adults. In contrast, in adolescents, the drug resistancerate to most tested drugs was lower than in adults. Primary transmission and inadequate treatment aretwo equally important factors for the high MDR-TB rate in children. Thus, major efforts in the TB controlin children should focus on decreasing the transmission of drug resistant TB and early testing of drugresistance.
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