Department of Science and Education Division and Department of Clinical Laboratory Medicine, Public Health Clinical Center of Chengdu, 377 Jingming Road, Jinjiang District, Chengdu, Sichuan, 610061, China.
Department of Clinical Laboratory Medicine, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China.
J Glob Antimicrob Resist. 2022 Mar;28:1-7. doi: 10.1016/j.jgar.2021.10.028. Epub 2021 Dec 14.
There are few reports on extrapulmonary tuberculosis/human immunodeficiency virus (EPTB/HIV) co-infection patients, especially the resistance profile of culture-confirmed EPTB. The purpose of our study was to analyse the clinical characteristics, common sites and drug resistance profile of culture-confirmed EPTB/HIV co-infection patients in Southwest China (2017-2020).
A total of 201 EPTB/HIV co-infection cases were selected for this study. Patient demographics and clinical characteristics were collected. Mycobacterium tuberculosis drug susceptibility testing (DST) was performed by the microporous plate method.
Among 2884 culture-confirmed EPTB cases, patients were predominantly male (1921/2884; 66.6%) and the mean age was 31 years. There were 201 patients (7.0%) with EPTB/HIV co-infection, among which 170 (84.6%) were male and the mean age was 42 years (range 13-86 years). During the 7-year study period, the mean number of EPTB/HIV co-infection cases was 29 per year (range 12-49 per year) at the studied institution. Diarrhoea, headache and fever were the most common presenting symptoms. DST showed resistance to any anti-TB drug in 62 isolates (30.8%), while multidrug-resistant TB and extensively drug-resistant TB were found in 14 (7.0%) and 10 (5.0%) cases, respectively. The distribution of EPTB tissue type was mainly meningeal and lymphatic, but varied between the sexes.
The immune level of EPTB/HIV co-infected patients was low and most were in advanced-stage AIDS. Patients were mainly young males and the site of EPTB was mainly meningeal and lymphatic. The most common symptoms were diarrhoea, headache and fever. High rates of drug resistance were found.
有关肺外结核/人类免疫缺陷病毒(EPTB/HIV)合并感染患者的报道较少,特别是培养确诊的 EPTB 的耐药谱。本研究的目的是分析中国西南地区(2017-2020 年)培养确诊的 EPTB/HIV 合并感染患者的临床特征、常见部位和耐药谱。
共选择了 201 例 EPTB/HIV 合并感染病例进行本研究。收集患者的人口统计学和临床特征。采用微孔板法进行结核分枝杆菌药物敏感性试验(DST)。
在 2884 例培养确诊的 EPTB 病例中,患者主要为男性(1921/2884;66.6%),平均年龄为 31 岁。有 201 例(7.0%)EPTB/HIV 合并感染患者,其中 170 例(84.6%)为男性,平均年龄为 42 岁(13-86 岁)。在 7 年的研究期间,该机构每年平均有 29 例 EPTB/HIV 合并感染病例(12-49 例/年)。腹泻、头痛和发热是最常见的首发症状。DST 显示 62 株(30.8%)对任何抗结核药物耐药,14 株(7.0%)和 10 株(5.0%)分别发现耐多药结核和广泛耐药结核。EPTB 组织类型的分布主要为脑膜和淋巴,但在不同性别间存在差异。
EPTB/HIV 合并感染患者的免疫水平较低,多数处于晚期艾滋病阶段。患者主要为年轻男性,EPTB 的部位主要为脑膜和淋巴。最常见的症状是腹泻、头痛和发热。耐药率较高。