意大利有症状肺结核（STB）和无症状肺结核（ATB）：一项多中心回顾性研究的结果

IF 2 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Pub Date : 2025-08-10 DOI:10.1016/j.jctube.2025.100556

Sergio Cotugno , Giacomo Guido , Francesco Di Gennaro , Francesco Cavallin , Mariantonietta Pisaturo , Lorenzo Onorato , Federica Zimmerhofer , Luca Pipitò , Giuseppina De Iaco , Giuseppe Bruno , Massimo Fasano , Agostina Pontarelli , Annarita Botta , Tiziana Iacovazzi , Rossana Lattanzio , Roberta Papagni , Elda De Vita , Alberto Zolezzi , Gianfranco Panico , Raffaella Libertone , Annalisa Saracino

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引用次数: 0

摘要

目的无症状结核病（ATB）占结核病（TB）病例的很大比例。本研究旨在比较ATB和症状性结核病（STB）病例在人口学和临床特征、不良事件、住院时间和治疗结果方面的差异。方法本多中心回顾性研究纳入了2018年至2023年间意大利10家医院的510例微生物学证实的肺结核患者。性病例至少有一种症状，如咳嗽、发热、胸痛、咯血、呼吸困难、盗汗或体重减轻。ATB病例无症状。终点包括不良事件、住院时间和治疗的不完全性。结果satb占36.4%（184/510）。STB与糖尿病（p = 0.03）、乙型/丙型肝炎感染(p <；0.0001)和结核病史（p = 0.01）。调整临床相关混杂因素后，STB与较高的不良事件发生率相关(优势比2.04,95%可信区间1.31 ~ 3.23；P = 0.002)，更严重的不良事件(优势比8.07,95%可信区间2.58 ~ 33.34；P = 0.001)，住院时间增加24%(95%置信区间为7%至47%；P = 0.005)，但与治疗不完全无关(优势比0.79,95%可信区间0.47 ~ 1.32；p = 0.37)。结论stb与较高的不良事件负担相关。由于ATB的无症状性，它对消除结核病提出了挑战。

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Symptomatic (STB) and Asymptomatic (ATB) tuberculosis in Italy: Results from a multicenter retrospective study

Objective

Asymptomatic tuberculosis (ATB) represents a significant proportion of tuberculosis (TB) cases. This study aimed to compare ATB and symptomatic TB (STB) cases in terms of demographic and clinical characteristics, adverse events, hospital length of stay, and treatment outcomes.

Methods

This multicenter retrospective study included 510 microbiologically confirmed pulmonary TB patients across ten Italian hospitals between 2018 and 2023. STB cases presented with at least one symptom such as cough, fever, chest pain, hemoptysis, dyspnea, night sweats or weight loss. ATB cases presented with no symptoms. The endpoints included adverse events, length of hospital stay, and incompleteness of the treatment.

Results

ATB accounted for 36.4 % of cases (184/510). STB was significantly associated with diabetes (p = 0.03), hepatitis B/C infections (p < 0.0001), and history of TB (p = 0.01). Adjusting for clinically relevant confounders, STB was associated with higher occurrence of adverse events (odds ratio 2.04, 95 % confidence interval 1.31 to 3.23; p = 0.002), more severe adverse events (odds ratio 8.07, 95 % confidence interval 2.58 to 33.34; p = 0.001) and a 24 % increase in length of hospital stay (95 % confidence interval 7 % to 47 %; p = 0.005), but was not associated with incomplete treatment (odds ratio 0.79, 95 % confidence interval 0.47 to 1.32; p = 0.37).

Conclusions

STB is associated with a higher burden of adverse events. ATB poses challenges for TB elimination due to its asymptomatic nature.

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来源期刊

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine

CiteScore

4.00

自引率

5.00%

发文量

审稿时长

30 weeks

期刊介绍： Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.