The Relationship between Extensively Drug-Resistant Tuberculosis and Multidrug-Resistant Gram-Negative Bacilli

TL;DR

This study found that patients with extensively drug-resistant tuberculosis are more likely to also have multidrug-resistant Gram-negative bacteria infections.

Contribution

The study identifies a significant association between XDR-TB and MDR-GNB infections in pulmonary TB patients.

Findings

XDR-TB patients had a 24.4% occurrence of MDR-GNB compared to 4.5% in non-XDR-TB patients.

XDR-TB was an independent risk factor for MDR-GNB infection (OR 6.56).

Abstract

The relationship between extensively drug-resistant tuberculosis (XDR-TB) and multidrug-resistant Gram-negative bacilli (MDR-GNB) is unclear. Identification of the relationship between XDR-TB and MDR-GNB would have important implications for patient care.

We conducted a retrospective study reviewing the records of patients admitted with a confirmed pulmonary TB from 2011 to 2014. To identify the relationship between XDR-TB and MDR-GNB, univariable comparison and multivariable logistic regression were performed.

Among 2962 pulmonary TB patients, 45(1.5%) patients had a diagnosis of XDR-TB. A total of 165 MDR-GNB strains were detected in 143 (4.8%) pulmonary TB patients. XDR-TB patients had a significantly higher occurrence of MDR-GNB than non-XDR-TB patients (24.4% vs. 4.5%; P<0.001). Age (OR 1.02, 95% CI 1.01–1.03), hypoalbuminemia (OR 1.48, 95% CI 1.18–1.85), chronic renal failure (OR 6.67, 95% CI 1.42–31.47), chronic hepatic insufficiency (OR 1.99, 95% CI 1.15–3.43), presence of XDR-TB (OR 6.56, 95% CI 1.61–26.69), and duration of TB diagnostic delay (OR 1.01, 95% CI 1.00–1.02) were the independent risk factors for MDR-GNB infection.

Patients with XDR-TB have a significantly higher risk of being affected by MDR-GNB pathogen. The underlying mechanism association warrant further studies.

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