Jing Ye, Qingpeng Yang, Yan Huang, Mei Lin, Xiaomin Xian, Liwen Huang, Huifang Qin, Chongxing Zhou, Yingkun Zhang, Xiaoyan Liang, Jin Ou, Zhezhe Cui
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引用次数: 0
Abstract
Background: The incidence and infection rate of Non-tuberculous Mycobacteria (NTM) are increasing across different regions, with regional variations in the types, distribution, and drug resistance profiles. Our objective was to investigate the risk factors, distribution of predominant Mycobacteria species, and phenotypic drug resistance profiles in co-infected HIV/AIDS patients in southern China.
Methods: Blood and sputum samples were collected from 2,985 HIV/AIDS patients without prior history of pulmonary tuberculosis (PTB) in five designated hospitals in Guangxi, southern China from January 2019 to December 2020. Univariate analysis and binary logistic regression models were used to explore the related risk factors of HIV/AIDS patients with NTM infection and those with Mycobacterium tuberculosis (MTB) infection, respectively. Interferon-γ release assay (IGRA) tests and CD4+ counts were performed on blood samples, Roche medium was used for sputum culture, and positive isolates underwent species identification and drug susceptibility testing.
Results: Mycobacterium tuberculosis and NTM culture positivity rates were 1.2% (35/2985) and 2.2% (66/2985), respectively (χ2 = 9.679, p = 0.002). Predominant NTM pathogens were Mycobacterium avium (28.8%, 19/66), Mycobacterium fortuitum (21.2%, 14/66), and Mycobacterium chelonae/abscessus complex (16.7%, 11/66). Multivariate analysis revealed cough (Adj. OR: 192.47, 95%CI: 15.71-2357.63, p < 0.001) and farming (Adj. OR: 20.92, 95%CI: 1.33-328.93, p = 0.031) as risk factors for NTM co-infection, whereas other pulmonary symptoms increased risk of MTB infection (Adj. OR: 3.37, 95% CI: 1.03-11.08, p = 0.045). Cough significantly differed between NTM and MTB groups (χ2 = 66.070, p < 0.001). Sixty-six NTM strains were tested for resistance to 10 common antibiotics. The drug resistance rates of para-aminosalicylic acid (PAS), Isoniazid (INH), Levofloxacin (LFX), Kanamycin (K), Ethambutol (EMB), Capreomycin (CPM), Rifampin (RFP), Moxifloxacin (MFX) and Amikacin (AM) exceeded 50.0%., while Protionamide (TH1321) was 25.8%. There was no significant in interferon status distribution across CD4+ counts groups (p = 0.574).
Conclusion: For HIV/AIDS patients presenting with cough symptoms, it is recommended that molecular biology techniques be employed concurrently with MTB testing to screen for and identify NTM, thereby clarifying the specific type of mycobacterial infection present. IGRA cannot completely distinguish MTB from NTM, and more auxiliary examinations are needed.
期刊介绍：
Frontiers in Public Health is a multidisciplinary open-access journal which publishes rigorously peer-reviewed research and is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians, policy makers and the public worldwide. The journal aims at overcoming current fragmentation in research and publication, promoting consistency in pursuing relevant scientific themes, and supporting finding dissemination and translation into practice.
Frontiers in Public Health is organized into Specialty Sections that cover different areas of research in the field. Please refer to the author guidelines for details on article types and the submission process.
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