Bacterial excretion in patients with HIV infection and tuberculosis


如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Objective. To analyze the rate of bacterial excretion among new-onset patients with HIV infection concurrent with tuberculosis (HIV/TB) in Novokuznetsk. Materials and methods. The rate of sputum TB pathogen detection using fluorescence microscopy and cultures on dense nutrient media was studied in all new-onset patients with respiratory TB and HIV infection who had been registered in Novokuznetsk in 2013-2014 (n = 362). 77.0% were men and 23.0% were women. Their mean age was 34.8 ± 8.1 years. Results. Data on CD4 lymphocyte counts were available in 294 (79.0%) patients; the median CD4 lymphocytes were 185 cells/ßl. Fluorescence sputum smear microscopy and cultures on dense nutrient media gave positive results in 58.6% and 64.1%, respectively. Bacterial excretion was more frequently recorded in severe immunosuppression (CD4 lymphocytes < 200 cells/ßl; p < 0.05). The rate of primary multidrug resistance was 51.9%, and its presence did not depend on the degree of immunosuppression. Fatal outcomes were significantly more common in patients with sputum smear-positive bacterial excretion results (46.7%) than in those with negative ones (30.1%;p < 0.005). Conclusion. Sputum TB pathogen was found by at least one of the phenotypic methods in 72.1% of the HIV-infected patients with new-onset respiratory TB. Bacterial excretion was more frequently found in patients with CD4 lymphocytes < 200 cells/ßl. The primary multidrug resistance rate was 51.9%.

全文:

受限制的访问

作者简介

I. Viktorova

Novokuznetsk State Institute for Postgraduate Training of Physicians, Branch, Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia

Email: irmaviktoroff@maiLru
Сand. Med. Sci., Associate Professor, Department of Phthisiopulmonology 5, Prospect Stroiteley, Novokuznetsk 654005, Russia Telephone/fax: +7(3843)-45-42-19

V. Zimina

Peoples' Friendship University of Russia

Email: vera-zim@yandex.ru
МБ, Professor, Department of Infectious Diseases with Courses of Epidemiology and Phthisiology Moscow, Russia

A. Kravchenko

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: kravtchenko@hivrussia.net
МБ, Leading Researcher Moscow, Russia

A. Khanin

Novokuznetsk State Institute for Postgraduate Training of Physicians, Branch, Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia

Email: prof.khanin@yandex.ru
Сand. Med. Sci., Head, Department of Phthisiopulmonology Novokuznetsk, Russia

参考

  1. Hargreaves N.J., Kadzakumanja O., Whitty C. J., Salaniponi F.M., Harries A.D., Squire S.B. «Smear-negative» pulmonary tuberculosis in a DOTS programme: poor outcomes in an area of high HIV seroprevalence. Int. J. Tuberc. Lung.Dis. 2001; (5): 847-54.
  2. Colebunders R., Bastian I. A review of the diagnosis and treatment of smear-negative pulmonary tuberculosis. Int. J. Tuberc. Lung. Dis. 2000; (4): 97-107.
  3. Kassu A., Mengistu G., Ayele B., Diro E., Mekonnen F., Ketema D. et al. Coinfection and clinical manifestations of tuberculosis in human immunodeficiency virus-infected and -uninfected adults at a teaching hospital, northwest Ethiopia. J.Microbiol. Immunol. Infect. 2007; 40: 116-22.
  4. Campos L.C., Rocha M.V.V., Willers D.M.C., Silva D.R. Characteristics of Patients with Smear-Negative Pulmonary Tuberculosis (TB) in a Region with High TB and HIV Prevalence. PLoS ONE 2016; 11(1): e0147933.
  5. Kibiki G.S., Mulder B., van der Ven A.J., Sam N., Boeree M.J., van der Zanden A. et al. Laboratory diagnosis of pulmonary tuberculosis in TB and HIV endemic settings and the contribution of real time PCR for M. tuberculosis in bronchoalveolar lavage fluid. Trop. Med. Int. Health. 2007; 12(10): 1210-7.
  6. Dimairo M., MacPherson P., Bandason T., Zezai A., Munyati S.S., Butterworth A.E. et al. The risk and timing of tuberculosis diagnosed in smear-negative TB suspects: a 12 month cohort study in Harare, Zimbabwe. PLoS One 2010; 5(7): e11849. doi: 10.1371/journal.pone.0011849
  7. Brouwer M., Brouwer M., Gudo P.S., Simbe C.M., Perdigao P., van Leth F. et al. Are routine tuberculosis programme data suitable to report on antiretroviral therapy use of HIV-infected tuberculosis patients? BMC Res. Notes. 2013; (6): 23. doi: 10.1186/1756-0500-6-23
  8. Desikan P. Sputum smear microscopy in tuberculosis: is it still relevant? Indian J. Med. Res. 2013; 137: 442-4.
  9. Пантелеев А.М. Туберкулез органов дыхания у больных ВИЧ-инфекцией. ВИЧ-инфекция и иммуносупрессия 2010; (1): 16-22.
  10. Teshome K.A., Anagaw Y.K. Outcome of tuberculosis treatment and its predictors among HIV infected patients in southwest Ethiopia. Int. J. Gen. Med. 2017; 10: 161-9. doi: 10.2147/IJGM.S135305.
  11. Swarooprani N.B., Mita D. Wadekar , Rajakumar S. Impact of CD4 Count on sputum smear for AFB in HIV/TB сoinfection. Indian J. Microbiol. Res. 2016; 3(2): 126-9.
  12. Linguissi L.S.G., Mayengue P.I., Sidibö A. et al. Prevalence of national treatment algorithm defined smear positive pulmonary tuberculosis in HIV positive patients in Brazzaville, Republic of Congo. BMC Res. Notes 2014; 7: 578. doi: 10.1186/1756-0500-7-578.
  13. Colebunders R., Bastian I. A review of the diagnosis and treatment of smear-negative pulmonary tuberculosis. Int. J. Tuberc. Lung Dis. 2000; (4): 97-107.
  14. Зимина В.Н., Микова О.Е., Варецкая Т.А., Дегтярева С.Ю., Сергевнин В.И. Выявление микобактерий туберкулеза в мокроте и массивность бактериовыделения у больных туберкулезом с различным ВИЧ-статусом. Туберкулёз и болезни лёгких 2017; 95(7): 17-23. doi: 10.21292/2075-1230-2017-95-7-17-23

补充文件

附件文件
动作
1. JATS XML
下载

版权所有 © Bionika Media, 2018
##common.cookie##