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BMC Infect Dis. 2016 Dec 12;16(1):750.

The characteristics of patients with mycobacterium tuberculosis blood stream infections in Beijing, China: a retrospective study.

Author information

1
Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China. liuxq@pumch.cn.
2
Clinical Epidemiology Unit, International Epidemiology Network, Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China. liuxq@pumch.cn.
3
Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
4
Clinical Epidemiology Unit, International Epidemiology Network, Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
5
Laboratory Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
6
Department of Infectious Diseases, Infection Control, and Employee Health, Unit 1460, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.

Abstract

BACKGROUND:

Published information regarding the clinical characteristics, laboratory findings, and outcomes of patients with Mycobacterium tuberculosis (MTB) blood stream infection (BSI) is limited. We aimed in this study to evaluate the clinical characteristics, laboratory evaluation, and outcomes of patients with MTB BSI.

METHODS:

All patients diagnosed with MTB BSI at Peking Union Medical College Hospital between January 2008 and May 2014 were identified by examining the electronic database listing results of all blood cultures. Data on demographics, clinical characteristics, laboratory manifestations, management, and outcomes were abstracted from medical records.

RESULTS:

Six thousand nine hundred seventy-four patients had mycobacterial blood cultures during the study period. Of 48 patients (0.7%) with MTB BSI, 26 patients (54%) were considered to be immunocompromised (refers to a person who has a significantly impaired immune system). This was due to human immunodeficiency virus (HIV) infection (n = 2 of 48 tested), receiving steroids (n = 17, including 16 with rheumatic diseases and one with myasthenia gravis), malignancy (n = 3), diabetes mellitus (n = 3), and renal transplantation (n = 1). The main clinical manifestations were fever (100%, with a median of 40 °C), weight loss (48%) and cough with sputum production (46%). Most patients had one or more organs involved (81%). The median time from onset of fever to diagnosis was 8 weeks (IQR 5 ~ 14). Six patients died within 1 week after diagnosis. Of the 17 patients completing treatment, 14 patients (82%) recovered without major complications and they had a shorter time interval between onsets of symptoms to treatment compared to those died of TB.

CONCLUSIONS:

In this group of patients with MTB BSI, fever and multiple organs involvement were common, the outcome was poor and timely diagnosis and treatment might favor outcome.

KEYWORDS:

Bacteremia; Blood stream infection; Mycobacterium tuberculosis

PMID:
27955709
PMCID:
PMC5153903
DOI:
10.1186/s12879-016-2084-z
[Indexed for MEDLINE]
Free PMC Article

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