Increased incidence of multidrug-resistant tuberculosis in diabetic patients on the Bellevue Chest Service, 1987 to 1997.
OBJECTIVE
To investigate the characteristics of tuberculosis infection in diabetic patients at Bellevue Hospital.


METHODS
We conducted a case-control study retrospectively reviewing the records of patients at Bellevue Hospital Center from 1987 to 1997 with a discharge diagnosis of tuberculosis and diabetes mellitus.


METHODS
Bellevue Hospital Center is a 1,200-bed, inner-city municipal hospital located in the Lower East Side of New York City.


METHODS
Fifty-three identified patients had verified tuberculosis infection and diabetes; of these, 50 charts were available for review. One hundred five control cases were selected from nondiabetic patients with a discharge diagnosis of tuberculosis during the same time period.


RESULTS
Thirty-six percent (18 cases) of the patients with diabetes and tuberculosis had multidrug-resistant tuberculosis (MDR-TB) compared to only 10% (10 cases) in the control group (p < 0.01) Controlling for homelessness, HIV status, and directly observed therapy, the relative risk of MDR-TB was calculated to be 8.6 (confidence interval, 3.1 to 23.6) in the diabetic group compared to the control group.


CONCLUSIONS
There was a significant association between diabetes and MDR-TB. Diabetes continues to be a risk factor for tuberculosis and was associated with MDR-TB in our patients.
Bashar
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Bellevue Chest Service, Division of Pulmonary and Critical Care Medicine, Department of Medicine and Environmental Medicine, New York University School of Medicine, New York 10016, USA.
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Condos
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D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology; D023801:Directly Observed Therapy; D005260:Female; D006679:HIV Seropositivity / Q000150:complications; D006703:Ill-Housed Persons; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000150:complications* / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000150:complications*