Fronti Elisa, Vecchia Marco, Scudeller Luigia, Praticò Liliana, Marone Piero, Muzzi Alba, Minoli Lorenzo, Seminari Elena
UO Malattie Infettive, Ospedale Guglielmo da Saliceto, Piacenza.
Clinica di Malattie Infettive, Fondazione IRCCS Policlinico San Matteo , Pavia, Italy.
New Microbiol. 2016 Oct;39(4):264-268. Epub 2016 Sep 13.
This study investigated the epidemiology of tuberculosis in the last 16 years in the province of Pavia, Lombardy, Northern Italy. The objective was to evaluate the clinical pattern of tuberculosis in immigrant groups compared with Italians in an observational retrospective study conducted from 1998 to 2013. In all, 615 tuberculosis cases were admitted, 354 males (57.3%), median age 47-years, 425 (69.1%) Italian-born patients, 190 (30.9%) immigrants. The ratio between the immigrant group and the Italian-born group of patients increased from 1.7% to 54.5% in the study period (p=0.001). HIV was the most common comorbidity, affecting 48 patients (7.8%), followed by diabetes in 35 (5.7%) and COPD in 30 (4.9%). The overall admission-associated mortality was 5.5%. Italian-born patients were older than non-Italian born subjects and had at least one comorbidity, 162 (38.1%) and 22 (11.6%), respectively (p<0,0001). Mortality was increased among Italian-born compared with non-Italian-born patients (7.3% versus 1.6%, p=0.004). No significant variation in extra-pulmonary tuberculosis (EPTB) prevalence occurred. Considering specific form of EPTB, HIV infection was associated with an increased risk of EPTB (RR 2.02, 95%CI 1.09-3.74, p=0.026). There was a high risk of tuberculosis among immigrants, whereas a decreasing trend was consistently observed among Italian-born patients. Italian-born patients show a higher tuberculosis-associated mortality risk due to older age and comorbidities.
本研究调查了意大利北部伦巴第大区帕维亚省过去16年的结核病流行病学情况。目的是在一项1998年至2013年进行的观察性回顾性研究中，评估移民群体与意大利本土人群相比的结核病临床模式。总共收治了615例结核病患者，其中男性354例（57.3%），中位年龄47岁，425例（69.1%）为意大利出生的患者，190例（30.9%）为移民。在研究期间，移民患者组与意大利出生患者组的比例从1.7%增至54.5%（p = 0.001）。HIV是最常见的合并症，影响48例患者（7.8%），其次是糖尿病35例（5.7%）和慢性阻塞性肺疾病30例（4.9%）。总体入院相关死亡率为5.5%。意大利出生的患者比非意大利出生的受试者年龄更大，且分别有162例（38.1%）和22例（11.6%）至少有一种合并症（p<0.0001）。与非意大利出生的患者相比，意大利出生患者的死亡率更高（7.3%对1.6%，p = 0.004）。肺外结核病（EPTB）患病率无显著变化。考虑到EPTB的特定形式，HIV感染与EPTB风险增加相关（相对危险度2.02，95%可信区间1.09 - 3.74，p = 0.026）。移民中结核病风险较高，而在意大利出生的患者中则持续观察到下降趋势。由于年龄较大和合并症，意大利出生的患者显示出更高的结核病相关死亡风险。
