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Evaluation of Culture-confirmed Extrapulmonary Tuberculosis Cases in a University Hospital
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RESEARCH ARTICLE
VOLUME: 8 ISSUE: 1
P: 31-31
January 2019

Evaluation of Culture-confirmed Extrapulmonary Tuberculosis Cases in a University Hospital

Mediterr J Infect Microb Antimicrob 2019;8(1):31-31
DOI: 10.4274/mjima.galenos.2019.2019.31
Sibel ALTUNIŞIK TOPLU 1
Üner KAYABAŞ 2
Barış OTLU 3
Yaşar BAYINDIR 1
Yasemin ERSOY 1
Funda MEMİŞOĞLU 1
1. İnönü University, Turgut Özal Medical Center Training and Research Hospital, Department of Infectious Diseases and Clinical Microbiology, Malatya, Turkey
2. Niğde Ömer Halisdemir University Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Niğde, Turkey
3. İnönü University Faculty of Medicine, Department of Medical Microbiology, Malatya, Turkey
No information available.
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Summary

Introduction: Tuberculosis (TB) is caused by Mycobacterium tuberculosis and can involve any organ, especially the lungs. In recent years, especially in developed countries, the incidence of TB has increased due to the growing number of people with acquired immunodeficiency. This has led to an increase in the incidence of extrapulmonary TB (EPTB). This study examined patients with EPTB confirmed by positive M. tuberculosis culture in İnönü University Faculty of Medicine, Department of Microbiology and Clinical Microbiology, Molecular Microbiology Laboratory.
Materials and Methods: Patients with positive M. tuberculosis culture in the molecular microbiology laboratory of our hospital between January 1, 2004 and December 31, 2014 were retrospectively evaluated according to culture-confirmed site of involvement, acid-fast bacillus (AFB), polymerase chain reaction (PCR) positivity, drug resistance, and mortality.
Results: The study included 132 patients; 41 (31.1%) were male and 91 (68.9%) were female. The mean age was 46.4±18.5 (17-86) years. Extrapulmonary TB types were TB lymphadenitis in 48 patients (36.4%), musculoskeletal TB in 23 (17.4%), disseminated TB in 17 (12.9%), urinary TB in 11 (8.3%), abdominal TB in 11 (8.3%), TB meningitis in eight (6.1%), pleural TB in six (4.5%), genital TB in five (3.8%), and cutaneous TB in three patients (2.3%). Acid-fast bacillus positivity rates were 21.7% in musculoskeletal samples, 16.6% in pleural samples, 12.5% in cerebrospinal fluid, 9% in urinary tract samples, and 6.2% in lymph nodes. Polymerase chain reaction positivity was not detected in cerebrospinal fluid or skin samples. The rate of resistance to at least one anti-tuberculous drug was 20%. Mortality was 16.1% (n=9) in the 56 patients (42.4%) with available data.
Conclusion: Lymphatic TB was the most common form in our patients. According to national data, pleural TB is among the common forms of EPTB in Turkey. However, the rate of pleural TB was low in our study due to the lack of pleural biopsy in our hospital during the study period. In TB-endemic regions such as Turkey, it is important to consider EPTB in the differential diagnosis of patients with relevant clinical findings and to confirm the diagnosis with TB culture primarily, as well as methods such as AFB staining and PCR.

References

1World Health Organization (WHO). Last accessed date: 2016 Nov 20. Available from: http://www.who.int/tb/publications/global_ report/en/
2Fitzgerald DW, Streling TR, Hass DW. Mycobacterium tuberculosis. In: Mandell GL, Bennett JE, Dolin R, (eds). Principles and Practice of Infectious Diseases. 7th ed. Philadelphia: Elsevier, 2010:3129-319.
3Di Nuzzo M, Trentini A, Grilli A, Massoli L, Biagi E, Maritati M, Contini C. Extrapulmonary tuberculosis among immigrants in a low-TB burden and high immigrant receiving city of northern Italy. J Infect Dev Ctries. 2018;12:73-9.
4Kayabaş Ü, Toplu SA. Akciğer Dışı Tüberküloz. İçinde: Topçu AW, Söyletir G, Doğanay M. (eds) Enfeksiyon Hastalıkları Mikrobiyolojisi, Sistemlere Göre Enfeksiyonlar 4. Baskı. Ankara: Nobel Tıp Kitabevleri, 2017:827-34.
5Eing BR, Becker A, Sohns A, Ringelmann R. Comparison of Roche Cobas Amplicor Mycobacterium tuberculosis Assay with In-House PCR and Culture for Detection of M. tuberculosis. J Clin Microbiol. 1998;36:2023-9.
6Hasibi M, Rasoulinejad M, Hosseini SM, Davari P, Sahebian A, Khashayar P. Epidemiological, Clinical, Laboratory Findings and Outcomes of Disseminated Tuberculosis in Tehran, Iran. South Med J. 2008;101:910-3.
7Klautau GB, Kuschnaroff TM. Clinical forms and outcomes of tuberculosisin HIV-infected patients in a tertiary hospital in Sao Paulo, Brazil. Braz J Infect Dis. 2005;9:464-78.
8Türkiye Cumhuriyeti Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü Türkiye’de Verem Savaşı 2017 Raporu. Baskı: Neyir Matbaacılık, Ankara, 2017.
9Shinnick TM, Good RC. Diagnostic mycobacteriology laboratory practices. Clin Infect Dis. 1995;21:291-9.
10Laal S. Immunodiagnosis. In: Rom WN, Garay SM (eds). Tuberculosis. 2nd ed. Lippincott Williams and Wilkins: Philadelphia USA, 2004;185-93.
11Lewinsohn DM, Leonard MK, LoBue PA, Cohn DL, Daley CL, Desmond E, Keane J, Lewinsohn DA, Loeffler AM, Mazurek GH, O’Brien RJ, Pai M, Richeldi L, Salfinger M, Shinnick TM, Sterling TR, Warshauer DM, Woods GL.Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children. Clin Infect Dis. 2017;64111-5.
12Pang Y, An J, Shu W, Huo F, Chu N, Gao M, Qin S, Huang H, Chen X, Xu S. Epidemiology of Extrapulmonary Tuberculosis among Inpatients, China, 2008-2017. Emerg Infect Dis. 2019;25:457-64.
13Taşbakan MS, Pullukçu H, Sipahi OR, Işıkgöz Taşbakan M, Ozkören Çalık S, Yamazhan T. Evaluation of 694 tuberculous lymphadenitis cases reported from Turkey between 1997-2009 period by pooled analysis method. Mikrobiyol Bul. 2010;44:385-93.
14Aljafari AS, Khalil EA, Elsiddig KE, El Hag IA, Ibrahim ME, Elsafi ME, Hussein AM, Elkhidir IM, Sulaiman GS, Elhassan AM. Diagnosis of Tuberculous Lymphadenitis By FNAC, Microbiological Methods And PCR: A Comparative Study. Cytopathology. 2004;15:44-8.
15Yassin MA, Olobo JO, Kidnae D, Negesse Y, Shimeles E, Tadesse A, Demissie A, Britton S, Harboe M, Aseffa A, Abate G. Diagnosis of tuberculous lymphadenitis in Butajira, rural Ethiopia. Scand J Infect Dis. 2003;35:240-3.
16Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res. 2004;120:316-53.
17Mondal SK. Histopathologic Analysis of Female Genital Tuberculosis: A Fifteen-Year Retrospective Study of 110 Cases in Eastern India. Turk Patoloji Derg. 2013;29:41-5.
18Gallouj S, Harmouch T, Karkos FZ, Baybay H, Meziane M, Sekal M, Amara B, Mikou O, Amarti A, Benjelloun MC, Mernissi FZ. Cutaneous tuberculosis: a 36-case series from Morocco. Med Trop (Mars). 2011;71:58-60.
19Dwari BC, Ghosh A, Paudel R, Kishore P. A clinicoepidemiological study of 50 cases of cutaneous tuberculosis in a tertiary care teaching hospital in pokhara, Nepal. Indian J Dermatol. 2010;55:233-7.
20Baykal C. Deri tüberkülozu: 64 olgunun retrospektif değerlendirmesi. Turkderm. 2001;35:103-8.
21Martin A, Portaels F. Drug resistance and drug resistance detection. In: Palamino JC, Leao SC, Ritacco V (eds). Tuberculosis 2007- From Basic Science to Patient Care. 1st ed. Flaying Publisher 2007;635-60.
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