INTRODUCTION: The epidemiological characteristics of patients with tuberculosis (TB) in European hospitals have changed in recent years. METHODS: A prospective study of patients with culture-proven pulmonary TB admitted to our institution from 1997 to 2008 is shown. RESULTS: We analyzed 661 patients with pulmonary TB. An increase in the incidence of TB was confirmed during the study period (P<.001). The proportion of patients with HIV infection decreased from 26% during 1997-2000 to 12% during 2005-2008. However, the proportions of older (>40 years old) and foreign-born patients increased significantly, from 37% to 59% and from 12% to 35%, respectively. Multivariate analysis confirmed previous antituberculous therapy and immigration as factors associated with resistance to isoniazid and to isoniazid+rifampin. After the year 2000, mortality was independently associated with extrapulmonary TB (OR: 3.1; CI 95%: 1.4-7.2), hepatitis C virus infection (OR: 6.0; CI 95%: 2.2-16.3), and diabetes (OR: 6.4; CI 95%: 2.4-16.8). CONCLUSION: Immigration from countries with high rates of TB infection has replaced HIV infection as the most relevant risk factor associated with TB. The increase in the number of older patients with TB and the presence of specific comorbid conditions, especially chronic liver dysfunction, could explain the more difficult management and increased mortality.
INTRODUCTION: The epidemiological characteristics of patients with tuberculosis (TB) in European hospitals have changed in recent years. METHODS: A prospective study of patients with culture-proven pulmonary TB admitted to our institution from 1997 to 2008 is shown. RESULTS: We analyzed 661 patients with pulmonary TB. An increase in the incidence of TB was confirmed during the study period (P<.001). The proportion of patients with HIV infection decreased from 26% during 1997-2000 to 12% during 2005-2008. However, the proportions of older (>40 years old) and foreign-bornpatients increased significantly, from 37% to 59% and from 12% to 35%, respectively. Multivariate analysis confirmed previous antituberculous therapy and immigration as factors associated with resistance to isoniazid and to isoniazid+rifampin. After the year 2000, mortality was independently associated with extrapulmonary TB (OR: 3.1; CI 95%: 1.4-7.2), hepatitis C virus infection (OR: 6.0; CI 95%: 2.2-16.3), and diabetes (OR: 6.4; CI 95%: 2.4-16.8). CONCLUSION: Immigration from countries with high rates of TB infection has replaced HIV infection as the most relevant risk factor associated with TB. The increase in the number of older patients with TB and the presence of specific comorbid conditions, especially chronic liver dysfunction, could explain the more difficult management and increased mortality.
Authors: J Fortún; P Martín-Dávila; E Gómez-Mampaso; A Vallejo; C Cuartero; A González-García; J Rubí; E Pallarés; S Moreno Journal: Infection Date: 2014-03-21 Impact factor: 3.553
Authors: Joaquín Salas-Coronas; María Teresa Cabezas-Fernández; Ana Belén Lozano-Serrano; Manuel Jesús Soriano-Pérez; José Vázquez-Villegas; José Ángel Cuenca-Gómez Journal: Am J Trop Med Hyg Date: 2018-01 Impact factor: 2.345
Authors: Christoph Lange; Ibrahim Abubakar; Jan-Willem C Alffenaar; Graham Bothamley; Jose A Caminero; Anna Cristina C Carvalho; Kwok-Chiu Chang; Luigi Codecasa; Ana Correia; Valeriu Crudu; Peter Davies; Martin Dedicoat; Francis Drobniewski; Raquel Duarte; Cordula Ehlers; Connie Erkens; Delia Goletti; Gunar Günther; Elmira Ibraim; Beate Kampmann; Liga Kuksa; Wiel de Lange; Frank van Leth; Jan van Lunzen; Alberto Matteelli; Dick Menzies; Ignacio Monedero; Elvira Richter; Sabine Rüsch-Gerdes; Andreas Sandgren; Anna Scardigli; Alena Skrahina; Enrico Tortoli; Grigory Volchenkov; Dirk Wagner; Marieke J van der Werf; Bhanu Williams; Wing-Wai Yew; Jean-Pierre Zellweger; Daniela Maria Cirillo Journal: Eur Respir J Date: 2014-03-23 Impact factor: 16.671