Abstract:

Objective To explore the distribution and drug resistance of pulmonary TB patients combined with extra-pulmonary TB.Methods A total of 347 PTB patients (male: 199, female: 148) with concurrent EPTB were recruited from Beijing Chest Hospital Capital Medical University between Jan 2013 and Dec 2015, of which the clinical data such as age, gender and co-infection sites were retrospectively reviewed, and drug resistance patterns were analyzed.Results The median age of the cases was 33 (24-52) years, and most patients were of 20-39 years old (41.8% (145/347)). Of the patients with concurrent EPTB, the types of TB disease included bone joint tuberculosis (n=112, 32.3%), lymph node tuberculosis (n=96, 27.7%), tuberculous meningitis (n=82, 23.6%) and tuberculous peritonitis (n=23, 6.6%), tuberculous pericarditis (n=9, 2.6%), intestinal tuberculosis (n=8, 2.3%), urinary tuberculosis (n=5, 1.4%), polyserositis tuberculousis (n=5, 1.4%), renal tuberculosis (n=2, 0.6%), splenic tuberculosis (n=1, 0.3%), pelvic tuberculosis (n=1, 0.3%), liver tuberculosis (n=1, 0.3%), epididymal tuberculosis (n=1, 0.3%) and nasal tuberculosis (n=1, 0.3%), respectively. The median ages of each group were 47 (26-60) years, 26 (20-42) years, 34 (25-50) years, 26 (20-46) years and 47 (31-66) years, respectively; there was significant difference among these groups (χ ²=36.25, P=0.000). The drug resistance patterns were analyzed in a total of 70 patients who had positive bacterial cultures. And 31 isolates were defined drug resistant, including 8 single-drug resistant, 2 poly-drug resistant and 21 multidrug resistant (MDR) isolates according to the drug susceptibility test outcomes. The overall resistant ratio was 44.3% (31/70), while the ratios of single drug resistance, poly-drug resistance and multi-drug resistance were 11.4% (8/70), 2.9% (2/70) and 30.0% (21/70), respectively.Conclusion Concurrent EPTB in PTB patients involves a wide range of types, of which the most common types are bone joint, lymph node and nervous system. The overall drug resistance ratio of PTB patients with concurrent EPTB is high.

Key words: Tuberculosis, pulmonary, Tuberculosis, osteoarticular, Tuberculosis, lymph node, Tuberculosis, meningeal, Tuberculosis, multidrug-resistant, Data interpretation, statistical