Background: is one of the most common pathogens leading to pulmonary tuberculosis (PTB) co-infection, but the data of co-infections is scarce. This research aimed to study the clinical and microbiological characteristics of co-infections in pulmonary tuberculosis cases.
Methods: Clinical manifestations and examination results of PTB cases co-infected by were retrospectively collected from the medical record database of a tertiary teaching hospital in China between November 2019 and October 2021. The strains isolated from the patients were sent for whole-genome sequencing. Statistical analyses were conducted using Stata v.14.0.
Results: A total of 80 strains were collected from 76 PTB patients with co-infections (two strains were isolated from each of the four patients at different time points), including 37 primary and 39 retreated TB cases. Among these, 29 (36.3%) of the isolates were extended-spectrum β-lactamase (ESBL)-producing strains, and seven (8.8%) were determined as carbapenem-resistant Enterobacteriaceae (CRE) strains. We found that patients in the multidrug resistance (MDR)-group received more respiratory support than the non-MDR group (40.6% vs 18.2%, = 0.031) and possessed higher elevated C-reactive protein (62.6% vs 41.8%, =0.008) and lower haemoglobin (87.5% vs 47.7%, =0.001). We found that 80.3% (61/76) patients had lung lesions and 57.8% (44/76) patients were immunocompromised within one month. The most common strain sequence type was ST23 (15%), followed by ST15 (12.5%) and ST273 (7.5%). Among the strains, 26.25% were classically hypervirulent K1/K2 , and all carried and .
Conclusion: This study demonstrated the important clinical features, phenotypic and genomic characteristics of isolated strains of PTB patients with co-infection. These data suggested a special attention for multidrug resistant infections with more obvious inflammatory responses which calls for more respiratory support and timely clinical management.
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| http://dx.doi.org/10.2147/IDR.S421587 | DOI Listing |
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