Drug resistance patterns among tuberculosis patients at a tuberculosis designated hospital in Yunnan: a retrospective analysis of the 2013-2022 period

Background Drug-resistant tuberculosis (TB) pose a significant impact on public health challenge in China. This study aimed to characterize the drug resistance patterns among TB patients at a designated tuberculosis hospital of Yunnan province over the past decade and identify risk factors associated with the severity of drug resistance. Methods Clinical data were retrospectively collected from The Third People's Hospital of Kunming City (a designated TB hospital in Yunnan) between 2013 and 2022. Inclusion criteria required patients with confirmed pulmonary TB who underwent phenotypic drug susceptibility test (DST) and had positive sputum culture results. Temporal trends of levels of resistance are visualized and statistically predicted by demographic characteristics using ordinal odds ratios from ordered logistic regression. Results Among 76,455 TB patients diagnosed during the study period, 4,303 had phenotypic DST results available. Most patients were aged 14-30 years. The incidence of most drug resistance types gradually declined after 2017, reaching the lowest levels in 2021, but increased thereafter. Male sex and middle age (30-60 years) being were significant risk factors for severe levels of drug-resistant tuberculosis. Conclusions Drug-resistant tuberculosis remains a public threat in the study area, especially in the above sub-populations. There is a need to conduct more studies to reveal the mechanisms of DR-TB transmission in these high-risk groups.