Cao Xiaolong, Song Zexuan, He Ping, Li Xinyue, Lei Nan, Sun Qian, Wang Xue, Xing Ruida, Zhao Bing, Yang Xinyu, Zhang Zhiguo, Zhao Yanlin
Chinese Center for Disease Control and Prevention, National Institute for Communicable Disease Control and Prevention, Beijing, 102206, China.
Beijing Changping Institute for Tuberculosis Prevention and Treatment, No. 4 He Ping Street, Changping District, Beijing, 102200, People's Republic of China.
BMC Infect Dis. 2025 Jan 22;25(1):101. doi: 10.1186/s12879-025-10470-z.
Diabetes mellitus (DM) is a major risk factor for tuberculosis (TB), However, limited research exists on their clinical and strain characteristics. This study aims to investigate the correlation between these factors in TB-DM patients in Changping District. METHODS: Whole genome sequencing (WGS) and drug susceptibility tests (DST) were performed on culture-positive strains. Spearman correlation analysis was used to examine risk factors and the correlation between lineage, cavities, and hemoptysis in the TB-DM population. The specificity, sensitivity, and confidence intervals for predicting phenotypic drug resistance based on genotypic resistance were calculated.
Among the 3924 TB patients, 292 had DM, showing a doubling in the proportion of TB patients with DM over seven years. Among the 144 etiologically positive TB-DM cases treated at the Changping Institute for Tuberculosis Prevention and Treatment, 75% (108/144) of the patients exhibited tuberculosis lesions that formed cavities and 12.5% (18/144) with hemoptysis. A statistically significant difference in cavity formation across different age groups was observed (r = -0.198, P < 0.05). Out of the 144 etiologically positive patients, WGS successfully revived 73 MTB strains, with Lineage 2 being predominant. No statistical difference was found between lineages and the presence of cavities or hemoptysis. The DST results showed the highest resistance rates to isoniazid and streptomycin, both at 8.2% (6/73), with approximately one-quarter of the strains resistant to at least one anti-TB drug, and about half (47.1%, 8/17) resistant to first-line drugs. The study demonstrated good specificity but suboptimal sensitivity in predicting phenotypic drug resistance based on genotypic resistance.
The rising incidence of diabetes in tuberculosis patients within Changping District has intensified the spread of TB, with these patients demonstrating severe illness and high drug resistance. This study aims to develop targeted prevention and management strategies, offering crucial guidance for treating co-infections of TB and DM and controlling disease spread.
糖尿病（DM）是结核病（TB）的主要危险因素，然而，关于它们的临床和菌株特征的研究有限。本研究旨在调查昌平区结核病合并糖尿病患者中这些因素之间的相关性。
对培养阳性菌株进行全基因组测序（WGS）和药敏试验（DST）。采用Spearman相关性分析来研究结核病合并糖尿病患者群体中的危险因素以及菌系、空洞和咯血之间的相关性。计算基于基因型耐药性预测表型耐药性的特异性、敏感性和置信区间。
在3924例结核病患者中，292例患有糖尿病，表明结核病合并糖尿病患者的比例在七年内翻了一番。在昌平区结核病防治所治疗的144例病因学确诊的结核病合并糖尿病病例中，75%（108/144）的患者出现了形成空洞的结核病变，12.5%（18/144）的患者出现咯血。不同年龄组在空洞形成方面存在统计学显著差异（r = -0.198，P < 0.05）。在144例病因学确诊的患者中，WGS成功复活了73株结核分枝杆菌菌株，其中2型菌系占主导。菌系与空洞或咯血的存在之间未发现统计学差异。DST结果显示对异烟肼和链霉素的耐药率最高，均为8.2%（6/73），约四分之一的菌株对至少一种抗结核药物耐药，约一半（47.1%，8/17）对一线药物耐药。该研究表明基于基因型耐药性预测表型耐药性具有良好的特异性，但敏感性欠佳。
昌平区结核病患者中糖尿病发病率的上升加剧了结核病的传播，这些患者病情严重且耐药性高。本研究旨在制定有针对性的预防和管理策略，为治疗结核病合并糖尿病的合并感染和控制疾病传播提供关键指导。
