Transmission Dynamics and Drug Resistance Profile of Mycobacterium tuberculosis complex in Non-elderly Populations During the COVID-19 Pandemic: An Age-stratified Comparative Study in Luoyang

LIU Jin-Wei; GUO Teng-Fei; XU Li-Yang; JIANG Shou; GAO Wei-Na; XUE Yun; YU Zhen-Zhen

Journal of Microbes and Infections ›› 2025, Vol. 20 ›› Issue (2) : 65-78.

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Abstract：This study aimed to investigate the dissemination and molecular drug resistance characteristics of Mycobacterium tuberculosis complex (MTBC) among non-elderly populations (<60 years old) attending tuberculosis-designated medical institutions in Luoyang during the COVID-19 pandemic from an age-stratified perspective. Sputum specimens from 16,631 patients (9,990 in the non-elderly group) at Luoyang Infectious Disease Hospital from 2020 to 2022 were analyzed using real-time fluorescence PCR to detect the MTBC-specific insertion sequence IS6110. Melting curve technology was applied to positive specimens to assess molecular drug resistance to isoniazid (INH), rifampin (RFP), streptomycin (SM), and ethambutol (EMB). Age-stratified comparisons were conducted to further reveal the MTBC dissemination and drug resistance patterns in non-elderly populations. During 2020-2022, sputum specimens from 16,631 patients (9,990 in the non-elderly group) were subjected to real-time fluorescence PCR for detecting the MTBC-specific insertion sequence IS6110. For positive specimens, melting curve technology was used to analyze the molecular drug resistance to isoniazid (INH), rifampin (RFP), streptomycin (SM), and ethambutol (EMB). Age-stratified comparisons of the experimental results were performed to further reveal the MTBC dissemination and drug resistance characteristics in non-elderly populations. The results revealed that both MTBC detection rates (15.9% vs. 13.8%) and the overall drug resistance rate (27.1% vs. 20.9%) were significantly higher in non-elderly individuals compared to the elderly group (all P < 0.001). Subgroup analysis indicated that among non-elderly populations males, retreatment patients, and the main urban population were high-burden subgroups with MTBC and drug resistance. The epidemic patterns of multidrug-resistant tuberculosis (MDR-TB) and poly-resistant tuberculosis (PDR-TB) were predominantly characterized by MDR3 (resistance to INH + RFP + SM) and PDR2 (resistance to INH + SM), with detection rates of 4.8% (77 cases) and 2.3% (37 cases) respectively. The study showed that non-elderly populations (<60 years old) are key drivers of tuberculosis transmission and drug resistance development in this region, with males, retreatment patients, and urban residents facing particularly prominent risks. It is recommended to implement targeted tuberculosis burden monitoring for this group, optimize life-cycle prevention and control strategies based on age-stratified characteristics, and provide a scientific basis for precision tuberculosis control in the post-COVID-19 era.

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Key words: Mycobacterium tuberculosis complex / non-elderly / infection / age stratification / molecular resistance

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Transmission Dynamics and Drug Resistance Profile of Mycobacterium tuberculosis complex in Non-elderly Populations During the COVID-19 Pandemic: An Age-stratified Comparative Study in Luoyang[J]. Journal of Microbes and Infections. 2025, 20(2): 65-78

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