Analysis of bacteriological positivity and rifampicin resistance in patients with severe pulmonary tuberculosis

doi:10.19982/j.issn.1000-6621.20240165

Abstract

Abstract:

Objective: To assess the bacteriological positivity rate and rifampicin resistance in sputum samples from patients with severe pulmonary tuberculosis. Methods: A retrospective analysis was conducted on 369 cases of pulmonary tuberculosis admitted to Beijing Chest Hospital, Capital Medical University, between January and December 2023, including 145 severe and 224 non-severe cases. The positive detection rates of Mycobacterium tuberculosis (MTB) in sputum samples were evaluated using acid-fast staining smear microscopy (smear), BACTEC MIGT 960 culture (culture), and Xpert MTB/RIF (Xpert). Rifampicin resistance was also assessed. Results: In severe pulmonary tuberculosis, the positive rates for smear, culture, and Xpert tests, as well as the overall bacteriological positivity rate, were 47.41% (55/116), 68.75% (77/112), 85.82% (115/134), and 80.69% (117/145), respectively. In non-severe cases, these rates were 29.44% (63/214), 53.17% (109/205), 68.35% (149/218), and 71.43% (160/224), respectively. The differences between severe and non-severe cases were statistically significant(χ²=10.580,P=0.001;χ²=7.250,P=0.007;χ²=12.512,P<0.001;χ²=4.034,P=0.045).There was no significant difference in rifampicin resistance rates between patients with severe pulmonary tuberculosis and those with non-severe cases (11.30% (13/115) vs. 8.05% (12/149);χ²=0.800, P=0.371). However, rifampicin resistance rates were higher in previously treated cases compared to new cases among Xpert-positive patients (24.24% (8/33) vs. 6.10% (5/82); χ²=7.727,P=0.005). Conclusion: Patients with severe pulmonary tuberculosis exhibited a higher bacteriological positivity rate; however, there was no significant difference in rifampicin resistance rates between severe and non-severe cases. Rifampicin resistance rates were notably higher in previously treated cases compared to newly diagnosed cases.

Key words: Tuberculosis, pulmonary, Microbiological techniques, Drug resistance, bacterial

CLC Number:

R521
R446.5

Geng Zimei, Wang Chaohong, Long Sibo, Zheng Maike, Shi Yiheng, Sun Yong, Zhao Yan, Wang Guirong. Analysis of bacteriological positivity and rifampicin resistance in patients with severe pulmonary tuberculosis[J]. Chinese Journal of Antituberculosis, 2024, 46(9): 1050-1055. doi: 10.19982/j.issn.1000-6621.20240165

Figures/Tables 2

References 19

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特征	重症肺结核(145例)	轻症肺结核(224例)	χ²值	P值
性别			2.931	0.087
男性	108(74.48)	148(66.07)
女性	37(25.52)	76(33.93)
年龄组(岁)			15.047	0.058
10~19	1(2.22)	6(2.68)
20~29	12(8.28)	27(12.05)
30~39	15(10.34)	16(7.14)
40~49	15(10.34)	23(10.27)
50~59	22(15.17)	41(18.30)
60~69	17(11.72)	43(19.20)
70~79	28(19.31)	39(17.41)
80~89	27(18.62)	25(11.16)
90~99	8(5.52)	4(1.79)
合并症
糖尿病	63(43.45)	93(41.52)	0.134	0.714
高血压	27(18.62)	81(36.16)	13.081	<0.001
冠心病	21(14.48)	48(21.43)	2.793	0.095
类风湿关节炎	3(2.07)	7(3.13)	-^a	0.746
尘肺	4(2.76)	2(0.90)	-^a	0.216
脑梗	14(9.66)	18(8.04)	0.291	0.589
帕金森	0(0.00)	2(0.90)	-	-
恶性肿瘤术后	5(3.45)	18(8.04)	3.169	0.075

检测方法	重症肺结核				轻症肺结核
检测方法	初治(107例)	复治(38例)	χ²值	P值	初治(136例)	复治(88例)	χ²值	P值
涂片法	42(51.22)	13(38.24)	1.625	0.202	49(37.40)	14(16.87)	10.316	0.001
培养法	51(65.38)	26(76.47)	1.355	0.244	75(61.98)	34(40.48)	9.211	0.002
Xpert法	82(85.42)	33(86.84)	0.045	0.831	92(69.70)	57(66.28)	0.423	0.515