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.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors: National Cheng Kung University Medical College, Graduate Institute of Microbiology and Immunology, Tainan, Taiwan.
authors: Jenn-Tyang
authors: JT
authors: Chang
authors: Horng-Yunn
authors: HY
authors: Dou
authors: Chia-Liang
authors: CL
authors: Yen
authors: Ying-Hsun
authors: YH
authors: Wu
authors: Ruay-Ming
authors: RM
authors: Huang
authors: Huey-Juan
authors: HJ
authors: Lin
authors: Ih-Jen
authors: IJ
authors: Su
authors: Chi-Chang
authors: CC
authors: Shieh
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D058491:Bacterial Load / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D016680:Genome, Bacterial; D006801:Humans; D008297:Male; D008875:Middle Aged; D009161:Mycobacterium / Q000187:drug effects / Q000235:genetics; D015995:Prevalence; D012720:Severity of Illness Index; D013624:Taiwan / Q000453:epidemiology; D017211:Treatment Failure; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents