Bacterial co-infection and early mortality among pulmonary tuberculosis patients in Manila, The Philippines
Bacterial co-infection and early mortality among pulmonary tuberculosis patients in Manila, The Philippines
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DOI：
10.5588/ijtld.17.0389
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发表时间：
2018-01-01
影响因子：
4
通讯作者：
Suzuki, M.
中科院分区：
文献类型：
--
作者：
Shimazaki, T.;Taniguchi, T.;Suzuki, M.
目的：探讨细菌合并感染的患病率及其对住院的人类免疫缺陷病毒（HIV）阴性肺结核（PTB）患者在马尼拉，菲律宾的早期死亡率的影响。设计：一项前瞻性观察性研究进行了国家传染病医院。入组了2011年11月至12月和2012年12月至2013年5月期间住院的HIV阴性PTB患者，年龄≥ 713岁。结果：466例患者中，228例（48.9%）结核分枝杆菌PCR阳性。总体而言，在135例（29.0%）患者的脓痰中检测到细菌病原体：流感嗜血杆菌是最常见的细菌（21.2%），其次是肺炎链球菌（7.9%）。TB-PCR阳性和阴性患者的细菌合并感染的患病率没有差异。共有92例（19.7%）患者在2周内死亡。在TB-PCR阳性患者中，细菌合并感染与2周死亡率风险增加显著相关（校正风险比[aRR] 1.67，95%CI 1.03-2.72）。在TB-PCR阴性患者中也观察到这种相关性，但未达到统计学显著性（aRR1.7，95%CI 0.95-3.02）。结论：细菌合并感染是常见的，并导致HIV阴性PTB患者早期死亡的风险增加。
OBJECTIVE : To investigate the prevalence of bacterial co-infection and its effect on early mortality among hospitalised human immunodeficiency virus (HIV) negative pulmonary tuberculosis (PTB) patients in Manila, the Philippines.DESIGN: A prospective observational study was conducted at a national infectious disease hospital. HIV-negative PTB patients age >= 713 years hospitalised from November to December 2011 and from December 2012 to May 2013 were enrolled. Sputum samples were tested for Mycobacterium tuberculosis and six respiratory bacterial pathogens using polymerase chain reaction (PCR).RESULTS : Of 466 patients, 228 (48.9%) were TB-PCR-positive. Overall, bacterial pathogens in purulent sputum were detected in 135 (29.0%) patients: Haemophilus influenzae was the most common bacterium (21.2%), followed by Streptococcus pneumoniae (7.9%). The prevalence of bacterial co-infection did not differ between TB-PCR-positive and -negative patients. A total of 92 (19.7%) patients died within 2 weeks. Bacterial co-infection was significantly associated with an increased risk of 2-week mortality among TB-PCR-positive patients (adjusted risk ratio [aRR] 1.67, 95% CI 1.03-2.72). This association was also observed but did not reach statistical significance among TB-PCR-negative patients (aRR1.7, 95% CI 0.95-3.02).CONCLUS ION: Bacterial co-infection is common and contributes to an increased risk of early mortality among HIV-negative PTB patients.