{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:18:15Z","timestamp":1783487895678,"version":"3.55.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Drug-resistant tuberculosis (DR-TB) remains a significant global health challenge, with increasing resistance to both first- and second-line anti-tuberculosis drugs. Understanding the demographic distribution, temporal trends, and resistance profiles of DR-TB is essential for improving treatment strategies and public health interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      This study aimed to examine the demographic characteristics, temporal distribution, and minimum inhibitory concentration (MIC) patterns of drug-resistant\n                      <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                      (\n                      <jats:italic>M. tuberculosis<\/jats:italic>\n                      ) isolates in a retrospective cohort of patients with culture-confirmed DR-TB from August 2019 to July 2023.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 402 drug-resistant\n                      <jats:italic>M. tuberculosis<\/jats:italic>\n                      isolates from clinical patients were included in this study for the analysis of MIC distributions and resistance trends over time. The study included four DR-TB categories: isoniazid-resistant TB, RR-TB, MDR-TB, and pre-XDR-TB. No XDR-TB cases were identified. The temporal distribution of cases was analyzed for seasonal trends, and MIC values were assessed for anti-tuberculosis drugs. A longitudinal analysis was conducted to observe variations in MICs over time. Specifically, a longitudinal comparison was performed on paired\n                      <jats:italic>M. tuberculosis<\/jats:italic>\n                      isolates from 49 patients, with isolates collected at intervals exceeding 4 weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The majority of patients were male (72.14%), and the most common form of DR-TB was isoniazid-resistant TB (23.14%). The study found significant seasonal variation, with higher DR-TB incidence in winter and spring months, and the temporal distribution was affected by COVID-19. Resistance rates were highest for isoniazid (40.30%), cycloserine (47.76%), and para-aminosalicylic acid (52.24%). Across the DR-TB cohorts, MICs for isoniazid, ethionamide, para-aminosalicylic acid, and amikacin demonstrated a significant upward trend, whereas a declining pattern was observed for ethambutol. The longitudinal comparison of paired\n                      <jats:italic>M. tuberculosis<\/jats:italic>\n                      isolates from 49 patients, demonstrated a marked elevation in the MICs for all 12 antimicrobials over the course of treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights the increasing burden of DR-TB, with increasing MICs and relatively high resistance rates for a few key drugs indicating reduced drug susceptibility over time. The increasing MICs highlight the need for continuous resistance monitoring and enhanced DR-TB control efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1866051","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T04:47:15Z","timestamp":1783486035000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Population-level and longitudinal MIC distributions for antimicrobials against drug-resistant Mycobacterium tuberculosis in Wuxi, a low-epidemic city in China, from 2019 to 2023"],"prefix":"10.3389","volume":"16","author":[{"given":"Song","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Chronic Infectious Disease Control and Prevention, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Affiliated Wuxi Fifth Hospital of Jiangnan University, The Fifth People\u2019s Hospital of Wuxi","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Chronic Infectious Disease Control and Prevention, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Chronic Infectious Disease Control and Prevention, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shipeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Chronic Infectious Disease Control and Prevention, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiya","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Chronic Infectious Disease Control and Prevention, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Affiliated Wuxi Fifth Hospital of Jiangnan University, The Fifth People\u2019s Hospital of Wuxi","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuping","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Chronic Infectious Disease Control and Prevention, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention","place":["Wuxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1099\/jmm.0.000534","article-title":"Minimum inhibitory concentration distributions for first- and second-line antimicrobials against Mycobacterium tuberculosis","volume":"66","author":"Burke","year":"2017","journal-title":"J. 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