{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:26:49Z","timestamp":1777922809606,"version":"3.51.4"},"reference-count":18,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T00:00:00Z","timestamp":1488326400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:p>\n                    With 25% of the global burden, China has the highest incidence of drug-resistant tuberculosis (TB) in the world. However, surveillance data on extensively drug-resistant TB (XDR-TB) from China are scant. To estimate the prevalence of XDR-TB in Zhejiang, Eastern China, 30 of 90 TB treatment centers in Zhejiang were recruited. Patients with suspected TB who reported to the clinics for diagnosis were requested to undergo a smear sputum test. Positive sputum samples were tested for drug susceptibility. Data on anti-TB drug resistance from 1999 to 2008 were also collected to assess drug resistance trends. A total of 931 cases were recruited for drug susceptibility testing (DST). Among these, 23.6% (95% confidence interval [CI], 18.8\u201324.4) were resistant to any of the following drugs: isoniazid, rifampin, streptomycin, and ethambutol. Multidrug resistant (MDR) strains were identified in 5.1% of all cases (95% CI, 3.61\u20136.49). Among MDR-TB cases, 6.4% were XDR (95% CI, 1.7\u201318.6) and 8.9% (95% CI, 7.0\u201310.8) of all cases were resistant to either isoniazid or rifampin (but not both). Among MDR-TB cases, 23.4% (95% CI, 12.8\u201338.4) were resistant to either fluoroquinolones or a second-line anti-TB injectable drug, but not both. From 1999 to 2014, the percentage of MDR cases decreased significantly, from 8.6% to 5.1% (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.00). The Global Fund to Fight TB program showed signs of success in Eastern China. However, drug-resistant TB, MDR-TB, and XDR-TB still pose a challenge for TB control in Eastern China. High-quality directly observed treatment, short-course, and universal DST for TB cases to determine appropriate treatment regimens are urgently needed to prevent acquired drug resistance.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2016.0075","type":"journal-article","created":{"date-parts":[[2016,10,18]],"date-time":"2016-10-18T16:41:49Z","timestamp":1476808909000},"page":"236-240","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Laboratory-Based Surveillance of Extensively Drug-Resistant Tuberculosis in Eastern China"],"prefix":"10.1177","volume":"23","author":[{"given":"Yu","family":"Huang","sequence":"first","affiliation":[{"name":"Zhejiang Provincial Center for Disease Control and Prevention","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingqing","family":"Wu","sequence":"additional","affiliation":[{"name":"Zhejiang Provincial Center for Disease Control and Prevention","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuiyang","family":"Xu","sequence":"additional","affiliation":[{"name":"Zhejiang Provincial Center for Disease Control and Prevention","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jieming","family":"Zhong","sequence":"additional","affiliation":[{"name":"Zhejiang Provincial Center for Disease Control and Prevention","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Songhua","family":"Chen","sequence":"additional","affiliation":[{"name":"Zhejiang Provincial Center for Disease Control and Prevention","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinghang","family":"Xu","sequence":"additional","affiliation":[{"name":"Zhejiang Provincial Center for Disease Control and Prevention","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"liping","family":"Zhu","sequence":"additional","affiliation":[{"name":"Zhejiang Provincial Center for Disease Control and Prevention","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haibo","family":"He","sequence":"additional","affiliation":[{"name":"Zhejiang Provincial Center for Disease Control and Prevention","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaomeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Zhejiang Provincial Center for Disease Control and Prevention","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,3]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"crossref","first-page":"1861","DOI":"10.1016\/S0140-6736(09)60331-7","article-title":"Epidemiology of antituberculosis drug resistance 2002\u201307: an updated analysis of the global project on anti-tuberculosis drug resistance surveillance","volume":"373","author":"Wright A.","year":"2009","unstructured":"Wright A., , Zignol M., , Van Deun A., , Falzon D., , Gerdes S.R., , Feldman K., , Hoffner S., , Drobniewski F., , Barrera L., , van Soolingen D., , Boulabhal F., , Paramasivan C.N., , Kam K.M., , Mitarai S., , Nunn P., , Raviglione M., and Global Project on Anti-Tuberculosis Drug Resistance Surveillance. 2009. Epidemiology of antituberculosis drug resistance 2002\u201307: an updated analysis of the global project on anti-tuberculosis drug resistance surveillance. Lancet, 373:1861\u20131873.","journal-title":"Lancet"},{"key":"e_1_3_4_3_2","unstructured":"World Health Organization. 2007. MDR-TB and XDR-TB response plan. Available at www.who.int\/tb\/challenges\/xdr\/xdr_mdr_factsheet_2007_en.pdf?ua=1"},{"key":"e_1_3_4_4_2","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.1056\/NEJMoa1108789","article-title":"National survey of drug-resistant tuberculis in China","volume":"366","author":"Zhao Y.","year":"2012","unstructured":"Zhao Y., , Xu S., , Wang L., , Chin D.P., , Wang S., , Jiang G., , Xia H., , Zhou Y., , Li Q., , Ou X., , Pang Y., , Song Y., , Zhao B., , Zhang H., , He G., , Guo J., , and Wang Y.. 2012. National survey of drug-resistant tuberculis in China. N. Engl. J. Med., 366:2161\u20132170.","journal-title":"N. Engl. J. Med."},{"key":"e_1_3_4_5_2","doi-asserted-by":"crossref","first-page":"496","DOI":"10.3201\/eid1803.110760","article-title":"Drug-resistant tuberculosis in Zhejiang province, China, 1999\u20132008","volume":"18","author":"Wang X.","year":"2012","unstructured":"Wang X., , Fu Q., , Li Z., , Liu Z., , Nelson H., , Yang Q., , Jia Z., , and Dye C.. 2012. Drug-resistant tuberculosis in Zhejiang province, China, 1999\u20132008. Emerg. Infect. Dis., 18:496\u2013498.","journal-title":"Emerg. Infect. Dis."},{"key":"e_1_3_4_6_2","unstructured":"World Health Organization. 2006. Guidelines for the programmatic management of drug-resistant tuberculosis. 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Characterization of extensively drug-resistant Mycobacterium tuberculosis clinical isolates in China. J. Clin. Microbiol., 46:4075\u20134077.","journal-title":"J. Clin. Microbiol."},{"key":"e_1_3_4_9_2","doi-asserted-by":"crossref","first-page":"e4370","DOI":"10.1371\/journal.pone.0004370","article-title":"Transmission of MDR and XDR tuberculosis in Shanghai, China","volume":"4","author":"Zhao M.","year":"2009","unstructured":"Zhao M., , Li X., , Xu P., , Shen X., , Gui X., , Wang L., , DeRiemer K., , Mei J., , and Gao Q.. 2009. Transmission of MDR and XDR tuberculosis in Shanghai, China. 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