Ongoz Ezgi, Aycicek Olcay, Bülbül Yilmaz, Öztuna Funda, Özlü Tevfik
Department of Chest Diseases, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
Medicine (Baltimore). 2025 Jul 4;104(27):e43202. doi: 10.1097/MD.0000000000043202.
In this study, we retrospectively evaluated the indications for chemoprophylaxis in active tuberculosis cases and reviewed the risk of latent tuberculosis infection (LTBI) progressing to active disease. Along with our decisions regarding LTBI treatment indications, we aimed to determine whether there were any shortcomings in this area. This study included 422 tuberculosis patients who were registered at the Provincial Central Tuberculosis Control Dispensary and diagnosed between 2016 and 2020. This was a single-center retrospective clinical study. These patients were evaluated in terms of latent tuberculosis treatment indication criteria in the Tuberculosis Diagnosis and Treatment Guide before they became patients with tuberculosis. All radiological images of the patients were evaluated. A total of 422 patients were included in this study. Of these, 147 (34.8%) were women, and 275 (65.2%) were men. When examining the distribution of patients according to the indications for latent tuberculosis infection treatment specified in the Ministry of Health's 2019 Tuberculosis Diagnosis and Treatment Guide, it was found that 6 (1.4%) patients were in contact with infectious cases, with 3 (50.0%) of these patients under 34 years old and 3 (50.0%) 35 years old or older. Prophylactic treatment was administered to 1 patient (33.3%) in the < 34 years age group. One patient with conversion was identified in the last 2 years, and it was noted that this patient received prophylaxis. Of the 153 patients with radiological findings compatible with tuberculosis sequelae, three (2.0%) received prophylaxis. According to the tuberculosis diagnosis and treatment guide, after adjusting for patients with common criteria, 164 (38.8%) patients were indicated for LTBI treatment. However, prophylaxis was only provided to 7 (4.2%) of these patients. The low rate of chemoprophylaxis observed in our study highlights the importance of diagnosing and monitoring LTBI. The data obtained will contribute to the diagnosis and treatment of LTBI.
在本研究中，我们回顾性评估了活动性肺结核病例的化学预防指征，并回顾了潜伏性结核感染（LTBI）进展为活动性疾病的风险。连同我们关于LTBI治疗指征的决定，我们旨在确定该领域是否存在任何不足之处。本研究纳入了422例在省级中央结核病防治所登记并于2016年至2020年期间确诊的结核病患者。这是一项单中心回顾性临床研究。这些患者在成为结核病患者之前，根据《结核病诊断和治疗指南》中的潜伏性结核治疗指征标准进行了评估。对患者的所有影像学图像进行了评估。本研究共纳入422例患者。其中，147例（34.8%）为女性，275例（65.2%）为男性。根据卫生部2019年《结核病诊断和治疗指南》中规定的潜伏性结核感染治疗指征对患者分布进行检查时，发现6例（1.4%）患者与传染性病例有接触，其中3例（50.0%）患者年龄在34岁以下，3例（50.0%）患者年龄在35岁及以上。在年龄<34岁的组中，1例患者（33.3%）接受了预防性治疗。在过去2年中发现1例血清学转换患者，且该患者接受了预防治疗。在153例影像学表现符合结核后遗症的患者中，3例（2.0%）接受了预防治疗。根据结核病诊断和治疗指南，在对符合常见标准的患者进行调整后，164例（38.8%）患者被指征进行LTBI治疗。然而，这些患者中只有7例（4.2%）接受了预防治疗。我们研究中观察到的化学预防率较低突出了诊断和监测LTBI的重要性。获得的数据将有助于LTBI的诊断和治疗。
