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2019-2021 年南京成人耐异烟肼和利福平敏感结核的危险因素。

Risk factors of adult isoniazid-resistant and rifampicin-susceptible tuberculosis in Nanjing, 2019-2021.

机构信息

Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, 321 Zhongshan Road, Nanjing, Jiangsu Province, 210008, PR China.

Department of Tuberculosis, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, 211132, China.

出版信息

BMC Infect Dis. 2024 May 22;24(1):511. doi: 10.1186/s12879-024-09404-y.

Abstract

INTRODUCTION

This study aimed to analyze the risk factors associated with isoniazid-resistant and rifampicin-susceptible tuberculosis (Hr-TB) in adults.

METHOD

The clinical data of 1,844 adult inpatients diagnosed with culture-positive pulmonary tuberculosis (PTB) in Nanjing Second Hospital from January 2019 and December 2021 were collected. All culture positive strain from the patient specimens underwent drug susceptibility testing (DST). Among them, 166 patients with Hr-TB were categorized as the Hr-TB group, while the remaining 1,678 patients were classified as having drug-susceptible tuberculosis (DS-TB). Hierarchical logistic regression was employed for multivariate analysis to identify variables associated with Hr-TB.

RESULTS

Multivariate logistic regression analysis revealed that individuals with diabetes mellitus (DM) (OR 1.472, 95% CI 1.037-2.088, p = 0.030) and a history of previous tuberculosis treatment (OR 2.913, 95% CI 1.971-4.306, p = 0.000) were at higher risk of developing adult Hr-TB, with this risk being more pronounced in male patients. Within the cohort, 1,640 patients were newly treated, and among them, DM (OR 1.662, 95% CI 1.123-2.461, p = 0.011) was identified as risk factors for Hr-TB.

CONCLUSIONS

Diabetes mellitus is a risk factor for Hr-TB in adults, and the contribution of diabetes as a risk factor was more pronounced in the newly treatment or male subgroup. And previous TB treatment history is also a risk factor for Hr-TB in adults.

摘要

目的

本研究旨在分析成人耐异烟肼和利福平肺结核(Hr-TB)相关的危险因素。

方法

收集 2019 年 1 月至 2021 年 12 月在南京第二医院住院的 1844 例成人培养阳性肺结核(PTB)患者的临床资料。所有患者的培养阳性菌株均进行药物敏感性试验(DST)。其中,166 例 Hr-TB 患者归入 Hr-TB 组,其余 1678 例为耐多药肺结核(DS-TB)患者。采用多变量逻辑回归分析鉴定与 Hr-TB 相关的变量。

结果

多变量逻辑回归分析显示,患有糖尿病(DM)(OR 1.472,95%CI 1.037-2.088,p=0.030)和既往结核病治疗史(OR 2.913,95%CI 1.971-4.306,p=0.000)的个体发生成人 Hr-TB 的风险更高,且男性患者的风险更高。在该队列中,1640 例患者为新治疗患者,其中糖尿病(OR 1.662,95%CI 1.123-2.461,p=0.011)是 Hr-TB 的危险因素。

结论

糖尿病是成人 Hr-TB 的危险因素,且糖尿病作为危险因素的贡献在新治疗或男性亚组中更为显著。既往结核病治疗史也是成人 Hr-TB 的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14c9/11110291/4ef9a7fbb27b/12879_2024_9404_Fig1_HTML.jpg

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