Aldriwesh Marwh G, Alaqeel Raghad A, Mashraqi Aisha M, Mashraqi Mutaib M, Albdah Bayan A, Alharbi Azzah S
Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
King Abdullah International Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.
Ann Thorac Med. 2022 Oct-Dec;17(4):229-236. doi: 10.4103/atm.atm_200_22. Epub 2022 Aug 26.
Little attention has been given to the development of lower respiratory tract infections (LRTIs) in patients with pulmonary tuberculosis (PTB) during their anti-tuberculosis (anti-TB) treatment and how that might affect patients' health status. Here, the prevalence and etiologies of other LRTIs in a cohort of PTB patients were determined, and the clinical features and outcomes were described.
Adult patients with PTB between 2015 and 2020 were recruited and monitored during their anti-TB treatment for the presence of LRTIs. Clinical data were retrospectively collected from patients' medical records.
Data from 76 PTB patients (57 [75%] males) were reviewed. The median age was 61.0 (interquartile range 83.5-35.5) years, and other LRTIs were detected in 45 (59.2%) PTB patients. Of the 126 episodes of LRTIs, 84 (66.7%) were due to bacterial infections, 37 (29.4%) were due to fungal infections, and 5 (3.9%) were due to viral infections. The development of LRTIs was significantly more common in older ( = 0.012) and hypertensive patients with PTB ( = 0.019). Patients with PTB and LRTIs experienced significantly more frequent extrapulmonary infections ( = 0.0004), bloodstream infections ( = 0.001), intensive care unit stays ( = 0.001), and invasive mechanical ventilation use ( = 0.03) than patients who did not develop LRTI.
The identification of host-related risk factors for LRTI development among patients with PTB could be used to develop a prediction model for LRTI development. Hence, initiating antimicrobials early, in parallel with appropriate anti-TB treatment, may mitigate PTB-related health and economic consequences.
肺结核（PTB）患者在抗结核治疗期间下呼吸道感染（LRTIs）的发生情况以及这可能如何影响患者的健康状况，一直未受到太多关注。在此，我们确定了一组PTB患者中其他LRTIs的患病率和病因，并描述了其临床特征和结局。
招募2015年至2020年期间的成年PTB患者，并在其抗结核治疗期间监测是否存在LRTIs。从患者病历中回顾性收集临床数据。
回顾了76例PTB患者（57例[75%]为男性）的数据。中位年龄为61.0岁（四分位间距83.5 - 35.5岁），45例（59.2%）PTB患者检测到其他LRTIs。在126次LRTIs发作中，84次（66.7%）是由细菌感染引起，37次（29.4%）是由真菌感染引起，5次（3.9%）是由病毒感染引起。LRTIs的发生在老年PTB患者（P = 0.012）和高血压PTB患者（P = 0.019）中明显更常见。与未发生LRTI的患者相比，患有PTB和LRTIs的患者肺外感染（P = 0.0004）、血流感染（P = 0.001）、入住重症监护病房（P = 0.001）和使用有创机械通气（P = 0.03）的频率明显更高。
确定PTB患者中LRTI发生的宿主相关危险因素可用于建立LRTI发生的预测模型。因此，在进行适当抗结核治疗的同时尽早启动抗菌药物治疗，可能减轻与PTB相关的健康和经济后果。
