Wamala Dan, Asiimwe Benon, Kigozi Edgar, Mboowa Gerald, Joloba Moses, Kallenius Gunilla
Department of Pathology, Mulago Hospital and Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda.
BMC Clin Pathol. 2014 Apr 2;14(1):14. doi: 10.1186/1472-6890-14-14.
Tuberculous lymphadenitis is next to pulmonary tuberculosis as the most common cause of tuberculosis. Uganda genotype, one of the sub-lineages of Mycobacterium tuberculosis, is the most prevalent cause of pulmonary tuberculosis in Uganda. We here investigate the clinicopathological characteristics of patients with tuberculous lymphadenitis infected with M. tuberculosis Uganda genotype compared with those infected with M. tuberculosis non-Uganda genotype strains.
Between 2010 and 2012, we enrolled 121 patients (mean age 28.5 yrs, male 48%; female 52%) with tuberculous lymphadenitis, and categorized them by their M. tuberculosis genotypes. The clinical features and lymph node cytopathological parameters were compared between patients in the Uganda and non-Uganda categories using a crude and multivariable logistic regression model with adjustment for confounding factors.
Of the 121participants, 56 (46%) were infected with strains of Uganda genotype. Patients infected with this genotype had significantly lower frequency of abdominal lymphadenopathy (odds ratio 0.4, p = 0.046) after adjusting for sex, age and HIV. Abdominal lymphadenopathy was also significantly associated with abnormal chest X-ray (p = 0.027).
Tuberculous lymphadenitis patients infected with M. tuberculosis Uganda genotype were significantly less prone to have abdominal lymphadenopathy indicating potential reduced ability to disseminate and supporting the concept that differences in M. tuberculosis genotype may have clinical implications.
结核性淋巴结炎是仅次于肺结核的第二大常见结核病病因。乌干达基因型是结核分枝杆菌的一个亚谱系,是乌干达肺结核最常见的病因。我们在此研究感染乌干达基因型结核分枝杆菌的结核性淋巴结炎患者与感染非乌干达基因型结核分枝杆菌菌株的患者的临床病理特征。
2010年至2012年期间,我们招募了121例结核性淋巴结炎患者(平均年龄28.5岁,男性占48%;女性占52%),并根据他们感染的结核分枝杆菌基因型进行分类。使用粗逻辑回归模型和多变量逻辑回归模型,并对混杂因素进行调整,比较乌干达组和非乌干达组患者的临床特征和淋巴结细胞病理学参数。
在121名参与者中,56例(46%)感染了乌干达基因型菌株。在对性别、年龄和艾滋病毒进行调整后,感染该基因型的患者腹部淋巴结病的发生率显著较低(优势比为0.4,p = 0.046)。腹部淋巴结病也与胸部X线异常显著相关(p = 0.027)。
感染乌干达基因型结核分枝杆菌的结核性淋巴结炎患者发生腹部淋巴结病的可能性显著较低,这表明其传播能力可能降低,并支持结核分枝杆菌基因型差异可能具有临床意义这一观点。