Clinical characteristics and outcomes of tuberculosis and non-tuberculous mycobacteria infections: a population-based study of concurrent and sequential infections.

IF 3.7 3区医学 Q2 INFECTIOUS DISEASES

European Journal of Clinical Microbiology & Infectious Diseases Pub Date : 2025-05-09 DOI:10.1007/s10096-025-05151-3

Zhen-Tao Fei, Dan-Ping Zhou, Wei Huang, Ping Liu, Qian-Ping Lu, Hao Li, Yang Yang, Dan Ye, Xu-Hui Liu, Lu Xia

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引用次数: 0

Abstract

Background: Co-infection with Tuberculosis (TB) and non-tuberculous mycobacteria (NTM) poses significant diagnostic and therapeutic challenges. This study investigates the demographic, clinical, and survival characteristics of these patients.

Methods: This retrospective study included patients diagnosed with TB, NTM, or TB + NTM co-infection at the Shanghai Public Health Clinical Center (2019-2022). Clinical, imaging, and survival data were collected and analyzed.

Results: A total of 400 patients were included: 33 in the TB + NTM group, 167 in the NTM-only group, and 200 in the TB-only group. Chest pain was more common in the TB + NTM group than the TB-only group (P = 0.006). The TB + NTM group exhibited a significantly lower body mass index (19.95 ± 3.51) and serum albumin level (36.09 ± 4.93 g/l), as well as a higher prevalence of hilar lymphadenopathy (45.5%) and cavitary lesions (39.4%), compared to the TB-only or NTM-only groups (P < 0.05). Miliary nodules were more frequent in the TB + NTM group (24.2%) compared to the TB-only group (11.0%, P = 0.048). A higher proportion of TB + NTM patients were from Central and Western China (P = 0.005). Survival analysis showed worse outcomes for the TB + NTM group (P = 0.038 vs. NTM-only, P = 0.008 vs. TB-only). Cox regression further identified a higher mortality risk in the TB + NTM group (adjusted hazard ratios = 2.468, 95% CI: 1.079-5.642, P = 0.032).

Conclusion: TB + NTM co-infection is associated with distinct clinical features and worse survival outcomes, emphasizing the need for early diagnosis and tailored treatment.

Clinical trial number: Not applicable.

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结核和非结核分枝杆菌感染的临床特征和结果：一项基于人群的并发和顺序感染研究。

背景：结核（TB）和非结核分枝杆菌（NTM）合并感染对诊断和治疗提出了重大挑战。本研究调查了这些患者的人口学、临床和生存特征。方法：本回顾性研究纳入2019-2022年上海公共卫生临床中心诊断为结核病、NTM或结核+ NTM合并感染的患者。收集并分析临床、影像学和生存数据。结果：共纳入400例患者：结核+ NTM组33例，单纯NTM组167例，单纯结核组200例。结核+ NTM组胸痛发生率高于单纯结核组（P = 0.006）。与单纯结核病或单纯NTM组相比，TB + NTM组的体重指数（19.95±3.51）和血清白蛋白水平（36.09±4.93 g/l）明显降低，肺门淋巴结病（45.5%）和空洞性病变（39.4%）患病率更高(P结论：TB + NTM合并感染具有明显的临床特征和较差的生存结果，强调早期诊断和治疗的必要性。临床试验号：不适用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Microbiology & Infectious Diseases 医学-传染病学

CiteScore

10.40

自引率

2.20%

发文量

138

审稿时长

1 months

期刊介绍： EJCMID is an interdisciplinary journal devoted to the publication of communications on infectious diseases of bacterial, viral and parasitic origin.