Molecular epidemiology of drug-resistant tuberculosis in Jiangxi Province, China, 2022–2023

Drug-resistant tuberculosis (DR-TB) poses a critical public health challenge in Jiangxi Province, China, where regional resistance patterns remain understudied. This retrospective study analyzed 9,041 suspected TB patients (2022-2023), identifying 3,104 <i>Mycobacterium tuberculosis</i> (<i>M. tuberculosis</i>) cases <i>via</i> PCR-reverse blot hybridization assay (PCR-REBA). Among <i>M. tuberculosis</i>-positive cases, 19.3% exhibited drug resistance, including mono- (9.2%), double- (4.6%), triple- (3.8%), and quadruple-drug resistance (1.7%). Males had higher odds of rifampicin (OR = 1.407, 95% CI: 1.086-1.824, <i>p</i> = 0.01) and isoniazid (OR = 1.959, 95% CI: 1.538-2.495, <i>p</i> < 0.001) resistance. Dominant mutations included <i>rpoB</i> Ser531Leu (32.1%) for rifampicin and <i>katG</i> Ser315Thr (53.6%) for isoniazid resistance. Extrapulmonary TB showed higher susceptibility than pulmonary TB (<i>e.g.</i>, rifampicin: 93.47% <i>vs.</i> 87.25%, <i>p</i> = 0.002). These findings highlight the urgent need for rapid molecular diagnostics and targeted interventions in Jiangxi to address distinct DR-TB patterns and demographic disparities.