{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:06:21Z","timestamp":1790867181121,"version":"4.1.0"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"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. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The situation of drug-resistant tuberculosis in China remains serious and complex. The majority of the study data are still derived from the 2,207 national survey of drug-resistant tuberculosis. In this study, we aimed to comprehensively characterize the prevalence of\n                      <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                      (MTB) in China and update the catalogue of drug-resistant mutations while accounting for geographic variability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      This study analyzed\n                      <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                      (\n                      <jats:italic>M. tuberculosis<\/jats:italic>\n                      ) isolates collected from 27 provinces, municipalities, and autonomous regions across China. All strains were analyzed for resistance to isoniazid, rifampicin, streptomycin, ethambutol, pyrazinamide, and quinolones based on the results of phenotypic drug sensitivity tests. The spatial and temporal distribution characteristics of drug-resistant strains were assessed based on the geographic origin and collection time of the isolates. The association between mutations and drug resistance was evaluated using mutation rates, positive predictive values, chi-square or Fisher\u2019s exact test\n                      <jats:italic>p<\/jats:italic>\n                      -values, and 95% confidence intervals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      55,388 MTB strains collected from 2002 to 2024 were analyzed, among which 15,078 were drug-resistant, including 7,848 multidrug-resistant strains. The resistance rates for INH, RFP, SM, EMB, PZA, and QS were 27.67, 25.33, 11.55, 6.19, 8.63, and 20.63%, respectively. Regional distribution patterns revealed that the eastern and western regions had the highest number of strains, but relatively low resistance rates. There was a low inflection point in 2019 for the resistance rates of all drugs except INH, whose resistance rate continued to increase after 2017. A total of 754 non-synonymous mutations were identified, with the highest mutation rates observed in INH (32.91%), RIF (28.98%), and QS (14.47%). The dominant mutation sites were\n                      <jats:italic>katG<\/jats:italic>\n                      (315AGC\u2009\u2192\u2009ACC),\n                      <jats:italic>rpoB<\/jats:italic>\n                      (531TCG\u2009\u2192\u2009TTG), and\n                      <jats:italic>gyrA<\/jats:italic>\n                      (94GAC\u2009\u2192\u2009GGC), respectively. In addition, 96 newly detected mutations potentially associated with drug resistance were identified, including\n                      <jats:italic>ahpC<\/jats:italic>\n                      (11CCG\u2009\u2192\u2009CCG) and\n                      <jats:italic>pncA<\/jats:italic>\n                      (226ACT\u2009\u2192\u2009CCT). Combined mutations were most frequently observed in\n                      <jats:italic>rpoB<\/jats:italic>\n                      +\n                      <jats:italic>rpoB<\/jats:italic>\n                      ,\n                      <jats:italic>katG<\/jats:italic>\n                      +\n                      <jats:italic>katG<\/jats:italic>\n                      , and\n                      <jats:italic>katG<\/jats:italic>\n                      +\n                      <jats:italic>inhA<\/jats:italic>\n                      , with other double-mutation combinations also being predominant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our analysis demonstrates that drug-resistant tuberculosis remains a serious challenge in China. Newly identified resistance-conferring mutations should be prioritized and integrated with the specific epidemiological characteristics of DR-TB in China to support the development and implementation of rapid diagnostic technologies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2025.1697490","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T06:29:49Z","timestamp":1765261789000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Drug resistance profile of Mycobacterium tuberculosis in China: update until 2024"],"prefix":"10.3389","volume":"16","author":[{"given":"Yannan","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sixuan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxiong","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianxiong","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liwei","family":"Gi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaocheng","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1111\/mmi.12476","article-title":"A silent mutation in mabA confers isoniazid resistance on Mycobacterium tuberculosis","volume":"91","author":"Ando","year":"2014","journal-title":"Mol. Microbiol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1556\/AMicr.58.2011.1.6","article-title":"Prevalence of mutations at codon 463 of katG gene in MDR and XDR clinical isolates of Mycobacterium tuberculosis in Belarus and application of the method in rapid diagnosis","volume":"58","author":"Arjomandzadegan","year":"2011","journal-title":"Acta Microbiol. Immunol. Hung."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.meegid.2013.06.008","article-title":"Mycobacterium tuberculosis isolates from Rio de Janeiro reveal unusually low correlation between pyrazinamide resistance and mutations in the pncA gene","volume":"19","author":"Bhuju","year":"2013","journal-title":"Infect. Genet. Evol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1056\/NEJMoa0907847","article-title":"Rapid molecular detection of tuberculosis and rifampin resistance","volume":"363","author":"Boehme","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e0185018","DOI":"10.1371\/journal.pone.0185018","article-title":"Why wait? The social determinants underlying tuberculosis diagnostic delay","volume":"12","author":"Bonadonna","year":"2017","journal-title":"PLoS One"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1186\/1471-2334-9-67","article-title":"Direct susceptibility testing for multi drug resistant tuberculosis: a meta-analysis","volume":"9","author":"Bwanga","year":"2009","journal-title":"BMC Infect. Dis."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"11626","DOI":"10.1038\/s41598-025-90089-x","article-title":"Diagnostic accuracy of nanopore sequencing for detecting mycobacterium tuberculosis and drug-resistant strains: a systematic review and meta-analysis","volume":"15","author":"Carandang","year":"2025","journal-title":"Sci. Rep."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1038\/ng.2878","article-title":"Evolution and transmission of drug-resistant tuberculosis in a Russian population","volume":"46","author":"Casali","year":"2014","journal-title":"Nat. Genet."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1128\/JCM.06095-11","article-title":"Genetic diversity and drug susceptibility of Mycobacterium tuberculosis isolates from Zunyi, one of the highest-incidence-rate areas in China","volume":"50","author":"Chen","year":"2012","journal-title":"J. Clin. Microbiol."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1138","DOI":"10.1093\/jac\/dkx506","article-title":"Evolution of drug resistance in Mycobacterium tuberculosis: a review on the molecular determinants of resistance and implications for personalized care","volume":"73","author":"Dookie","year":"2018","journal-title":"J. Antimicrob. Chemother."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1038\/ng.2747","article-title":"Genomic analysis identifies targets of convergent positive selection in drug-resistant Mycobacterium tuberculosis","volume":"45","author":"Farhat","year":"2013","journal-title":"Nat. Genet."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2220","DOI":"10.1128\/JCM.00429-13","article-title":"Predictive value of molecular drug resistance testing of Mycobacterium tuberculosis isolates in Valle del Cauca, Colombia","volume":"51","author":"Ferro","year":"2013","journal-title":"J. Clin. Microbiol."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/j.eimc.2014.04.005","article-title":"Characterization of phenotypic and genotypic drug resistance patterns of Mycobacterium tuberculosis isolates from a city in Mexico","volume":"33","author":"Flores-Trevi\u00f1o","year":"2015","journal-title":"Enferm. Infecc. Microbiol. Clin."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1093\/femsre\/fux011","article-title":"Antimicrobial resistance in Mycobacterium tuberculosis: mechanistic and evolutionary perspectives","volume":"41","author":"Gygli","year":"2017","journal-title":"FEMS Microbiol. Rev."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"4613","DOI":"10.21037\/jtd.2019.11.03","article-title":"Phenotypic and genotypic characterization of levofloxacin- and moxifloxacin-resistant Mycobacterium tuberculosis clinical isolates in southern China","volume":"11","author":"Hameed","year":"2019","journal-title":"J. Thorac. Dis."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s12866-018-1168-x","article-title":"Mutations of rpoB, katG, inhAand ahp genes in rifampicin and isoniazid-resistant Mycobacterium tuberculosis in Kyrgyz Republic","volume":"18","author":"Isakova","year":"2018","journal-title":"BMC Microbiol."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"781","DOI":"10.4102\/ajlm.v7i2.781","article-title":"Drug resistant tuberculosis in Africa: current status, gaps and opportunities","volume":"7","author":"Ismail","year":"2018","journal-title":"Afr J Lab Med."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2369","DOI":"10.1093\/jac\/dku161","article-title":"Detection of mutations associated with isoniazid resistance in multidrug-resistant Mycobacterium tuberculosis clinical isolates","volume":"69","author":"Jagielski","year":"2014","journal-title":"J. Antimicrob. Chemother."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1007\/s10096-014-2202-z","article-title":"A close-up on the epidemiology and transmission of multidrug-resistant tuberculosis in Poland","volume":"34","author":"Jagielski","year":"2015","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1186\/1471-2180-10-223","article-title":"Surveillance of pyrazinamide susceptibility among multidrug-resistant Mycobacterium tuberculosis isolates from Siriraj hospital, Thailand","volume":"10","author":"Jonmalung","year":"2010","journal-title":"BMC Microbiol."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"579","DOI":"10.2147\/IDR.S196800","article-title":"Characterization of the most common embCAB gene mutations associated with ethambutol resistance in Mycobacterium tuberculosis isolates from Iran","volume":"12","author":"Khosravi","year":"2019","journal-title":"Infect Drug Resist."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1768","DOI":"10.1128\/AAC.40.8.1768","article-title":"Gyrase mutations in laboratory-selected, fluoroquinolone-resistant mutants of Mycobacterium tuberculosis H37Ra","volume":"40","author":"Kocag\u00f6z","year":"1996","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e01003","DOI":"10.1128\/AAC.01003-20","article-title":"How to optimally combine genotypic and phenotypic drug susceptibility testing methods for pyrazinamide","volume":"64","author":"K\u00f6ser","year":"2020","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.jgar.2019.03.012","article-title":"Characterisation of drug resistance-associated mutations among clinical multidrug-resistant Mycobacterium tuberculosis isolates from Hebei Province, China","volume":"18","author":"Li","year":"2019","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1080\/10409238.2025.2470630","article-title":"Catalase-peroxidase (katG): a potential frontier in tuberculosis drug development","volume":"59","author":"Liu","year":"2024","journal-title":"Crit. Rev. Biochem. Mol. Biol."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"731.e9","DOI":"10.1016\/j.cmi.2021.09.014","article-title":"Whole-genome sequencing for surveillance of tuberculosis drug resistance and determination of resistance level in China","volume":"28","author":"Liu","year":"2022","journal-title":"Clin. Microbiol. Infect."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1038\/s41426-018-0184-0","article-title":"The impact of combined gene mutations in inhAand ahpC genes on high levels of isoniazid resistance amongst katG non-315 in multidrug-resistant tuberculosis isolates from China","volume":"7","author":"Liu","year":"2019","journal-title":"Emerg. Microbes Infect."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1016\/j.jgar.2020.03.008","article-title":"Prevalence and patterns of drug resistant pulmonary tuberculosis in India-a systematic review and meta-analysis","volume":"22","author":"Lohiya","year":"2020","journal-title":"J Glob Antimicrob Resist."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"7315","DOI":"10.1038\/s41598-019-43547-2","article-title":"Prevalence and molecular characterization of multidrug-resistant M. tuberculosis in Jiangxi province, China","volume":"9","author":"Luo","year":"2019","journal-title":"Sci. Rep."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"e01214","DOI":"10.1128\/JCM.01214-17","article-title":"Multi- and extensively drug resistant Mycobacterium tuberculosis in South Africa: a molecular analysis of historical isolates","volume":"56","author":"Maningi","year":"2018","journal-title":"J. Clin. Microbiol."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1183\/09031936.00036812","article-title":"Protecting the tuberculosis drug pipeline: stating the case for the rational use of fluoroquinolones","volume":"40","author":"Migliori","year":"2012","journal-title":"Eur. Respir. J."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"2004077","DOI":"10.1183\/13993003.04077-2020","article-title":"Targeted next-generation sequencing: a Swiss army knife for mycobacterial diagnostics?","volume":"57","author":"Mohamed","year":"2021","journal-title":"Eur. Respir. J."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"3810","DOI":"10.1128\/JCM.40.10.3810-3813.2002","article-title":"Detection of embB306 mutations in ethambutol-susceptible clinical isolates of Mycobacterium tuberculosis from northwestern Russia: implications for genotypic resistance testing","volume":"40","author":"Mokrousov","year":"2002","journal-title":"J. Clin. Microbiol."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1111\/cbdd.12684","article-title":"A note on derivatives of isoniazid, rifampicin, and pyrazinamide showing activity against resistant Mycobacterium tuberculosis","volume":"87","author":"Nusrath Unissa","year":"2016","journal-title":"Chem. Biol. Drug Des."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"100899","DOI":"10.1016\/S2666-5247(24)00131-9","article-title":"The catalogue of Mycobacterium tuberculosis mutations associated with drug resistance to 12 drugs in China from a nationwide survey: a genomic analysis","volume":"5","author":"Pei","year":"2024","journal-title":"Lancet Microbe."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1016\/j.ijantimicag.2010.11.023","article-title":"Detection of novel coupled mutations in the katG gene (His276Met, Gln295His, and Ser315Thr) in a multidrug-resistant Mycobacterium tuberculosis strain from Chennai, India, and insight into the molecular mechanism of isoniazid resistance using structural bioinformatics approaches","volume":"37","author":"Ramasubban","year":"2011","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"e2","DOI":"10.1371\/journal.pmed.1000002","article-title":"Tuberculosis drug resistance mutation database","volume":"6","author":"Sandgren","year":"2009","journal-title":"PLoS Med."},{"key":"ref38","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1586\/14737159.2015.976556","article-title":"Evaluation of the Cepheid Xpert MTB\/RIF assay","volume":"15","author":"Shinnick","year":"2015","journal-title":"Expert. Rev. Mol. Diagn."},{"key":"ref39","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1128\/AAC.46.2.443-450.2002","article-title":"Molecular characterization of multidrug-resistant isolates of Mycobacterium tuberculosis from patients in North India","volume":"46","author":"Siddiqi","year":"2002","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref40","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.jgar.2015.11.009","article-title":"Mutations in rrs, rpsL and gidB in streptomycin-resistant Mycobacterium tuberculosis isolates from Thailand","volume":"4","author":"Smittipat","year":"2016","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1186\/s12879-022-07482-4","article-title":"Prediction of drug resistance profile of multidrug-resistant Mycobacterium tuberculosis (MDR-MTB) isolates from newly diagnosed cases by whole genome sequencing (WGS): a study from a high tuberculosis burden country","volume":"22","author":"Sun","year":"2022","journal-title":"BMC Infect. Dis."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1128\/JCM.01903-13","article-title":"Role of pncA and rpsA gene sequencing in detection of pyrazinamide resistance in Mycobacterium tuberculosis isolates from southern China","volume":"52","author":"Tan","year":"2014","journal-title":"J. Clin. Microbiol."},{"key":"ref43","year":"2025"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1016\/j.meegid.2016.09.004","article-title":"Overview on mechanisms of isoniazid action and resistance in Mycobacterium tuberculosis","volume":"45","author":"Unissa","year":"2016","journal-title":"Infect. Genet. Evol."},{"key":"ref45","doi-asserted-by":"publisher","first-page":"e265","DOI":"10.1016\/S2666-5247(21)00301-3","article-title":"The 2021 WHO catalogue of Mycobacterium tuberculosis complex mutations associated with drug resistance: a genotypic analysis","volume":"3","author":"Walker","year":"2022","journal-title":"Lancet Microbe."},{"key":"ref46","doi-asserted-by":"publisher","first-page":"1444","DOI":"10.3389\/fmicb.2020.01444","article-title":"Genomic analysis identifies mutations concerning drug-resistance and Beijing genotype in multidrug-resistant Mycobacterium tuberculosis isolated from China","volume":"11","author":"Wan","year":"2020","journal-title":"Front. Microbiol."},{"key":"ref47","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1016\/j.jinf.2021.02.004","article-title":"Prevalence and molecular characterizations of seven additional drug resistance among multidrug-resistant tuberculosis in China: a subsequent study of a national survey","volume":"82","author":"Wang","year":"2021","journal-title":"J. Infect."},{"key":"ref48","doi-asserted-by":"publisher","first-page":"e22","DOI":"10.1017\/S095026882100279X","article-title":"Whole-genome sequencing of Mycobacterium tuberculosis for prediction of drug resistance","volume":"150","author":"Wang","year":"2022","journal-title":"Epidemiol. Infect."},{"key":"ref49","doi-asserted-by":"publisher","first-page":"5783","DOI":"10.2147\/IDR.S423955","article-title":"Analysis of drug-resistance characteristics and genetic diversity of multidrug-resistant tuberculosis based on whole-genome sequencing on the Hainan Island, China","volume":"16","author":"Wang","year":"2023","journal-title":"Infect. Drug Resist."},{"key":"ref50","year":"2025"},{"key":"ref51","year":"2022"},{"key":"ref52","volume-title":"Catalogue of mutations in","year":"2023"},{"key":"ref53","year":"2024"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.meegid.2018.11.012","article-title":"pncA gene mutations in reporting pyrazinamide resistance among the MDR-TB suspects","volume":"72","author":"Wu","year":"2019","journal-title":"Infect. Genet. Evol."},{"key":"ref55","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.1111\/resp.13078","article-title":"Tuberculosis in China: a longitudinal predictive model of the general population and recommendations for achieving WHO goals","volume":"22","author":"Xu","year":"2017","journal-title":"Respirology"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.jinf.2010.05.001","article-title":"Mutation characterization of gyrA and gyrB genes in levofloxacin-resistant Mycobacterium tuberculosis clinical isolates from Guangdong Province in China","volume":"61","author":"Yin","year":"2010","journal-title":"J. Infect."},{"key":"ref57","doi-asserted-by":"publisher","first-page":"e0075422","DOI":"10.1128\/spectrum.00754-22","article-title":"Differential impact of the rpoB mutant on rifampin and Rifabutin resistance signatures of Mycobacterium tuberculosis is revealed using a whole-genome sequencing assay","volume":"10","author":"Yu","year":"2022","journal-title":"Microbiol Spectr."},{"key":"ref58","doi-asserted-by":"publisher","first-page":"300060521997596","DOI":"10.1177\/0300060521997596","article-title":"rpoB gene mutations in rifampin-resistant Mycobacterium tuberculosis isolates from rural areas of Zhejiang, China","volume":"49","author":"Zeng","year":"2021","journal-title":"J. Int. Med. Res."},{"key":"ref59","doi-asserted-by":"publisher","first-page":"2161","DOI":"10.1056\/NEJMoa1108789","article-title":"National survey of drug-resistant tuberculosis in China","volume":"366","author":"Zhao","year":"2012","journal-title":"N. Engl. J. 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