Wang Dong-Mei, An Qi, Yang Qing, Liao Yi, Jian Yao
Department of Science and Education Division, Public Health Clinical Center of Chengdu, Chengdu, Sichuan, China.
Department of Clinical Laboratory Medicine, School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Front Med (Lausanne). 2023 Feb 7;10:1051620. doi: 10.3389/fmed.2023.1051620. eCollection 2023.
Osteoarticular tuberculosis (TB) is an uncommon form of extrapulmonary TB. In this study, we analyzed the epidemiological characteristics, common sites, and drug resistance profiles of osteoarticular TB infections occurring in southwest China.
A total of 3,254 cases of patients clinically diagnosed with osteoarticular TB infections between 2013 and 2021 were retrospectively analyzed. Patients' demographic and clinical characteristics were collected. Drug sensitivity testing was performed using the microporous plate ratio method. Chi-squared analysis was used to analyze the rates of and trends in mycobacterial isolates.
Of the 3,254 patients, 1,968 (60.5%) were men and boys, and 1,286 (39.5%) were women and girls; patients' ages ranged from 1 to 91 years, with an average of 42 ± 19.3 years. In terms of disease, 2,261 (69.5%) had spinal TB, mainly thoracic (815, 36%) or lumbar (1,080, 48%); joint TB was found in 874 cases (26.9%), mainly occurring in the knee (263, 30%) or hip (227, 26%); and both spinal and joint TB were observed in 119 cases (3.7%). Drug susceptibility tests were performed on 241 isolated strains of MTB; 70 strains (29.0%) were resistant to at least one drug, and MDR-TB and XDR-TB were observed in 7.1 and 1.2% of strains, respectively.
In southwest China over this period, osteoarticular TB mainly affected middle-aged and young men with poor nutritional status. Patients from ethnic minority areas also accounted for a large proportion of cases. Spinal TB is prone to occur in the lumbar and thoracic vertebrae, and joint TB is prone to occur in the lower limb joints. Additionally, there has been an increasing trend in the number of TB cases over the past 9 years, and drug resistance has also increased.
骨关节结核是肺外结核的一种少见形式。在本研究中，我们分析了中国西南部骨关节结核感染的流行病学特征、常见部位及耐药情况。
回顾性分析了2013年至2021年间临床诊断为骨关节结核感染的3254例患者。收集患者的人口统计学和临床特征。采用微孔板比例法进行药敏试验。采用卡方分析来分析分枝杆菌分离株的比例和趋势。
3254例患者中，1968例（60.5%）为男性和男孩，1286例（39.5%）为女性和女孩；患者年龄为1至91岁，平均年龄为42±19.3岁。在疾病方面，2261例（69.5%）患有脊柱结核，主要为胸椎结核（815例，36%）或腰椎结核（1080例，48%）；关节结核874例（26.9%），主要发生在膝关节（263例，30%）或髋关节（227例，26%）；119例（3.7%）同时患有脊柱和关节结核。对241株结核分枝杆菌分离株进行了药敏试验；70株（29.0%）对至少一种药物耐药，耐多药结核和广泛耐药结核分别占分离株的7.1%和1.2%。
在此期间的中国西南部，骨关节结核主要影响营养状况较差的中青年男性。少数民族地区的患者也占很大比例。脊柱结核易发生在腰椎和胸椎，关节结核易发生在下肢关节。此外，过去9年结核病病例数呈上升趋势，耐药性也有所增加。
