Effect of Type 2 Diabetes Mellitus on the Clinical Severity and Treatment Outcome in Patients With Pulmonary Tuberculosis: A Potential Role in the Emergence of Multidrug-resistance
A globally increasing trend of type 2 diabetes mellitus (DM), the rising prevalence of tuberculosis (TB) in many countries, and the emergence of multidrug-resistant TB (MDR-TB) in recent years pose a serious challenge for TB control. Methods: We investigated pulmonary tuberculosis patients with and...
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| Format: | Article |
| Language: | English |
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Elsevier
2011-06-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664611600557 |
| _version_ | 1818416091668414464 |
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| author | Jenn-Tyang Chang Horng-Yunn Dou Chia-Liang Yen Ying-Hsun Wu Ruay-Ming Huang Huey-Juan Lin Ih-Jen Su Chi-Chang Shieh |
| author_facet | Jenn-Tyang Chang Horng-Yunn Dou Chia-Liang Yen Ying-Hsun Wu Ruay-Ming Huang Huey-Juan Lin Ih-Jen Su Chi-Chang Shieh |
| author_sort | Jenn-Tyang Chang |
| collection | DOAJ |
| description | A globally increasing trend of type 2 diabetes mellitus (DM), the rising prevalence of tuberculosis (TB) in many countries, and the emergence of multidrug-resistant TB (MDR-TB) in recent years pose a serious challenge for TB control.
Methods: We investigated pulmonary tuberculosis patients with and without type 2 DM (DMTB and TB, respectively) treated at the Chest Hospital, Taiwan, between November 2004 and October 2005.
Results: One hundred and ninety-two new patients (60 DMTB, 132 TB) were regularly treated for a full course (≥ 6 months) and prospectively followed for more than 1 year. The DMTB patients had more severe infections (far-advanced: 45.0% vs. 22.7%, p < 0.01), higher mycobacterial loads (sputum smear: 2.9 ± 1.3+ vs. 1.9 ± 1.7+, p < 0.01), higher treatment failure rates (17% vs. 2%, p < 0.01), and longer delayed clearance of mycobacteria than did the TB patients (2.5 ± 3.0 months vs. 1.6 ± 1.4 months, p < 0.01). After one year, three DMTB patients and one TB patient had MDR-TB (5.0% vs. 0.8%, p = 0.056). Bacterial genotyping revealed that the proportion of mycobacterial strains was not significantly different in DMTB and TB patients (Beijing strain: 46.7% vs. 40.6%, Non-Beijing strain: 53.3% vs. 59.4%, p = 0.632).
Conclusion: DMTB patients have more severe TB infections, which require longer treatment and are more likely to develop MDR-TB than are patients with TB alone. |
| first_indexed | 2024-12-14T11:45:23Z |
| format | Article |
| id | doaj.art-e33bbfc1e5104d20919f3e18ef9c5c65 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-14T11:45:23Z |
| publishDate | 2011-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-e33bbfc1e5104d20919f3e18ef9c5c652022-12-21T23:02:37ZengElsevierJournal of the Formosan Medical Association0929-66462011-06-01110637238110.1016/S0929-6646(11)60055-7Effect of Type 2 Diabetes Mellitus on the Clinical Severity and Treatment Outcome in Patients With Pulmonary Tuberculosis: A Potential Role in the Emergence of Multidrug-resistanceJenn-Tyang Chang0Horng-Yunn Dou1Chia-Liang Yen2Ying-Hsun Wu3Ruay-Ming Huang4Huey-Juan Lin5Ih-Jen Su6Chi-Chang Shieh7National Cheng Kung University Medical College, Graduate Institute of Microbiology and Immunology, Tainan, TaiwanDivision of Clinical Research, National Health Research Institutes, Zhunan, TaiwanNational Cheng Kung University Medical College, Graduate Institute of Microbiology and Immunology, Tainan, TaiwanChest Hospital, Tainan, TaiwanChest Hospital, Tainan, TaiwanChi-Mei Foundation Hospital, Tainan, TaiwanDivision of Clinical Research, National Health Research Institutes, Zhunan, TaiwanNational Cheng Kung University Medical College, Graduate Institute of Microbiology and Immunology, Tainan, TaiwanA globally increasing trend of type 2 diabetes mellitus (DM), the rising prevalence of tuberculosis (TB) in many countries, and the emergence of multidrug-resistant TB (MDR-TB) in recent years pose a serious challenge for TB control. Methods: We investigated pulmonary tuberculosis patients with and without type 2 DM (DMTB and TB, respectively) treated at the Chest Hospital, Taiwan, between November 2004 and October 2005. Results: One hundred and ninety-two new patients (60 DMTB, 132 TB) were regularly treated for a full course (≥ 6 months) and prospectively followed for more than 1 year. The DMTB patients had more severe infections (far-advanced: 45.0% vs. 22.7%, p < 0.01), higher mycobacterial loads (sputum smear: 2.9 ± 1.3+ vs. 1.9 ± 1.7+, p < 0.01), higher treatment failure rates (17% vs. 2%, p < 0.01), and longer delayed clearance of mycobacteria than did the TB patients (2.5 ± 3.0 months vs. 1.6 ± 1.4 months, p < 0.01). After one year, three DMTB patients and one TB patient had MDR-TB (5.0% vs. 0.8%, p = 0.056). Bacterial genotyping revealed that the proportion of mycobacterial strains was not significantly different in DMTB and TB patients (Beijing strain: 46.7% vs. 40.6%, Non-Beijing strain: 53.3% vs. 59.4%, p = 0.632). Conclusion: DMTB patients have more severe TB infections, which require longer treatment and are more likely to develop MDR-TB than are patients with TB alone.http://www.sciencedirect.com/science/article/pii/S0929664611600557Beijing straindiabetes mellitusmultidrug-resistant tuberculosispulmonary tuberculosisspoligotype analysis |
| spellingShingle | Jenn-Tyang Chang Horng-Yunn Dou Chia-Liang Yen Ying-Hsun Wu Ruay-Ming Huang Huey-Juan Lin Ih-Jen Su Chi-Chang Shieh Effect of Type 2 Diabetes Mellitus on the Clinical Severity and Treatment Outcome in Patients With Pulmonary Tuberculosis: A Potential Role in the Emergence of Multidrug-resistance Journal of the Formosan Medical Association Beijing strain diabetes mellitus multidrug-resistant tuberculosis pulmonary tuberculosis spoligotype analysis |
| title | Effect of Type 2 Diabetes Mellitus on the Clinical Severity and Treatment Outcome in Patients With Pulmonary Tuberculosis: A Potential Role in the Emergence of Multidrug-resistance |
| title_full | Effect of Type 2 Diabetes Mellitus on the Clinical Severity and Treatment Outcome in Patients With Pulmonary Tuberculosis: A Potential Role in the Emergence of Multidrug-resistance |
| title_fullStr | Effect of Type 2 Diabetes Mellitus on the Clinical Severity and Treatment Outcome in Patients With Pulmonary Tuberculosis: A Potential Role in the Emergence of Multidrug-resistance |
| title_full_unstemmed | Effect of Type 2 Diabetes Mellitus on the Clinical Severity and Treatment Outcome in Patients With Pulmonary Tuberculosis: A Potential Role in the Emergence of Multidrug-resistance |
| title_short | Effect of Type 2 Diabetes Mellitus on the Clinical Severity and Treatment Outcome in Patients With Pulmonary Tuberculosis: A Potential Role in the Emergence of Multidrug-resistance |
| title_sort | effect of type 2 diabetes mellitus on the clinical severity and treatment outcome in patients with pulmonary tuberculosis a potential role in the emergence of multidrug resistance |
| topic | Beijing strain diabetes mellitus multidrug-resistant tuberculosis pulmonary tuberculosis spoligotype analysis |
| url | http://www.sciencedirect.com/science/article/pii/S0929664611600557 |
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