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非结核分枝杆菌肺病及定植患者中潜伏结核感染的患病率:在一个中等结核病负担国家的前瞻性研究

Prevalence of Latent Tuberculous Infection in Patients With Nontuberculous Mycobacterial Lung Disease and Colonization: A Prospective Study in an Intermediate Tuberculosis Burden Country.

作者信息

Lee Ho-Sheng, Wei Yu-Feng, Tsai Yi-Jung, Wang Ping-Huai, Chen Chung-Yu, Pan Sheng-Wei, Shu Chin-Chung

机构信息

Department of Internal Medicine, E-Da Hospital, Kaohsiung City, Taiwan.

School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan.

出版信息

Open Forum Infect Dis. 2022 Feb 9;9(3):ofac072. doi: 10.1093/ofid/ofac072. eCollection 2022 Mar.

Abstract

BACKGROUND

Controlling latent tuberculosis infection (LTBI) is important in eliminating tuberculosis (TB); however, the prevalence of LTBI has rarely been studied in patients with nontuberculous mycobacterial (NTM) lung disease (LD) and colonization (LC).

METHODS

We prospectively recruited subjects with NTM isolated from sputum mycobacterial cultures from December 2011 to June 2019. NTM-LD and NTM-LC were defined according to the American Thoracic Society guidelines. Patients with negative cultures were recruited as controls. Patients with a history of active TB or positive TB cultures were excluded. LTBI was confirmed using a QuantiFERON-TB Gold In-tube test. The prevalence and factors associated with LTBI were analyzed.

RESULTS

A total of 406 participants were enrolled, including 171 in the NTM-LD group, 153 in the NTM-LC group, and 82 in the control group. The prevalence of LTBI was higher in the NTM-LD and NTM-LC groups than in the controls (21.6%, 20.9%, and 6.1%;  = .006). Multivariable analysis showed that old age (adjusted odds ratio [aOR], 1.021, per year increment;  = .042), NTM-LD (aOR, 4.030;  = .005), NTM-LC (aOR, 3.610;  = .011, compared with the controls), and pulmonary cavitary lesions (aOR, 3.393;  = .034) were independently associated with LTBI.

CONCLUSIONS

The prevalence of LTBI was higher in the patients with NTM-LD and NTM-LC than in the controls. Old age, pulmonary cavitation, and NTM isolated from sputum were associated with a higher risk of LTBI.

摘要

背景

控制潜伏性结核感染(LTBI)对于消除结核病(TB)很重要;然而,非结核分枝杆菌(NTM)肺病(LD)和定植(LC)患者中LTBI的患病率很少被研究。

方法

我们前瞻性地招募了2011年12月至2019年6月从痰分枝杆菌培养物中分离出NTM的受试者。NTM-LD和NTM-LC根据美国胸科学会指南定义。培养结果为阴性的患者被招募为对照组。有活动性结核病史或结核培养阳性的患者被排除。使用全血γ-干扰素释放试验(QuantiFERON-TB Gold In-tube test)确认LTBI。分析LTBI的患病率及相关因素。

结果

共纳入406名参与者,包括NTM-LD组171名、NTM-LC组153名和对照组82名。NTM-LD组和NTM-LC组的LTBI患病率高于对照组(分别为21.6%、20.9%和6.1%;P = 0.006)。多变量分析显示,老年(校正比值比[aOR],每年增加1.021;P = 0.042)、NTM-LD(aOR,4.030;P = 0.005)、NTM-LC(与对照组相比,aOR,3.610;P = 0.011)和肺部空洞性病变(aOR,3.393;P = 0.034)与LTBI独立相关。

结论

NTM-LD和NTM-LC患者的LTBI患病率高于对照组。老年、肺部空洞形成以及痰中分离出NTM与LTBI风险较高相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd73/8883589/b0a2a2ef74b5/ofac072_fig1.jpg

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