Song WM, Li YF, Ma XB, et al. - Given the contribution of primary drug-resistant tuberculosis (DR-TB) to significant health and economic burden especially in China, researchers estimated epidemiological features of primary DR-TB in China from 2004 to 2018. This inquiry included 11,467 newly diagnosed and 1,981 retreated TB cases with drug susceptibility data. Findings revealed a downward trend in the total rate of drug resistance among new TB cases in Shandong, China, from 2004 to 2018. A shift of primary drug resistance patterns from female, non-cavity, isoniazide-resistant TB, and mono-resistant TB groups to male, cavity, rifampicin/streptomycin-resistant TB, and multiresistant TB groups was also noted. Taking into account the increasing drug resistance rate among some special population, an increased focus on female, cavity, smoking, drinking, or 15 to 44 year-old TB subgroups may be needed in order to achieve future control of primary DR-TB in China.