Drug resistance characteristics of Mycobacterium tuberculosis isolates obtained between 2015 and 2024 in Zhengzhou, China

The prevalence and evolution of drug resistance in TB pose a persistent threat to global TB control. Understanding the epidemiological characteristics, population distribution, and temporal trends of drug resistance is crucial for evaluating the effectiveness of prevention and control measures and adjusting strategies accordingly. This study retrospectively analyzed 9,665 clinical isolates of Mycobacterium TB collected between 2015 and 2024. Drug susceptibility testing was performed using the proportion method to detect resistance to isoniazid, rifampicin, ethambutol, streptomycin, and levofloxacin. The chi-square test was used to compare differences between groups, and the chi-square test for trend was applied to analyze temporal changes in drug resistance. The overall drug resistance rate was 20.87% (2017/9665, 95% CI: 20.06%-21.69%), and the MDR rate was 10.25% (991/9665, 95% CI: 9.66%-10.88%). Drug resistance rates varied significantly among different populations, with males (1528/6730,22.70%; 95% CI: 21.71%-23.72%) exhibiting higher rates than females (489/2935,16.66%; 95% CI: 15.33%-18.06%), and the 19–59 age group (1511/6788,22.26%; 95% CI: 21.27%-23.27%) showing higher rates than the ≤ 18 (124/694,17.87%; 95% CI: 15.09%-20.92%) and ≥ 60 age groups (382/2183, 17.50%; 95% CI: 15.93%-19.16%). Over the ten-year period, the overall drug resistance rate showed a significant upward trend (from 17.29% to 22.98%). Rates of single drug resistance, PDR, and resistance to streptomycin and levofloxacin also increased significantly. In contrast, the MDR rate and resistance rates to rifampicin and ethambutol did not show significant trends. The TB drug resistance problem in this region is severe, with a rapid increase in resistance to the key second-line drug levofloxacin, indicating significant challenges for the current prevention and control system. Targeted interventions for populations with higher resistance rates, such as males and young adults, along with strengthened antibiotic stewardship, are critical to curbing the further spread of drug resistance.