Positive Culture Mycobacterial Infections. Clinic Characteristics, Risk Factors, and Sensitivity Profil

Abstract

PURPOSE: Analyzed data from in hospital patients with positive culture mycobacterial tuberculosis in a teaching hospital in Colombia a high prevalence country for tuberculosis. METHODS: We conducted a descriptive, observational retrospective that included patients with Mycobacterium sp confirmed by culture in the period between 2004 and 2010 at Hospital Pablo Tobon Uribe. RESULTS: We analyzed data from 204 hospitalized patients with mycobacterial infection between 2004 and 2010, 187 patients had positive cultures and were included in the analysis. Mean age was 40± 20.8, 64% were men. The most frequent symptom was fever in 66.8% followed by respiratory symptoms in 59% of patients. The main baseline pathologies was chronic steroids use 13.3%, other immunosupresive drugs 12%, renal chronic disease in 9.6%, diabetes mellitus and solid organ transplantation in 8% respectively. Twenty three percent of patients had HIV coinfection. Lung was the most prevalent frequent site in 47% of the patients. The most common extrapulmonary diseases were; pleural 9.6 %, node 7.2 %, gastrointestinal 7 % and bone 4.2%. Disseminated TB was in 14.4%. The species more frequently identified was M. tuberculosis in 90%. We find 10% of non tuberculous mycobacterial, principally M. avium. Sensitivity to first line treatment was found in 55% of isolations, 5% were Multidrug resistant and just 2% were classified as extensively drug resistance. The in-hospital mortality was 10% and in those who died, in 82% the death was attributable to the infection. CONCLUSIONS: The general characteristics of patients treated at the HPTU with tuberculosis are similar to those reported in the literature. It is striking, however, the high prevalence of coinfection with HIV virus in our series as well as the largest hospital mortality than those reported in other studies in Latin America, related to the level of complexity of our institution. The immunocompromised patients are a population highly vulnerable and at risk to develop extra-pulmonary tuberculosis or disseminated tuberculosis. CLINICAL IMPLICATIONS: To our knowledge this is the first study of its kind in Colombia, a better understanding of patients infected by M. tuberculosis requiring hospital treatment will help us to optimize their management.