title: Tuberculosis and the risk of infection with other intracellular bacteria: a population-based study.
abstract: SUMMARY Persons who develop tuberculosis (TB) may have subtle immune defects that could predispose to other intracellular bacterial infections (ICBIs). We obtained data on TB and five ICBIs (Chlamydia trachomatis, Salmonella spp., Shigella spp., Yersinia spp., Listeria monocytogenes) reported to the Tennessee Department of Health, USA, 2000-2011. Incidence rate ratios (IRRs) comparing ICBIs in persons who developed TB and ICBIs in the Tennessee population, adjusted for age, sex, race and ethnicity were estimated. IRRs were not significantly elevated for all ICBIs combined [IRR 0.87, 95% confidence interval (CI) 0.71-1.06]. C. trachomatis rate was lowest in the year post-TB diagnosis (IRR 0.17, 95% CI 0.04-0.70). More Salmonella infections occurred in extrapulmonary TB compared to pulmonary TB patients (IRR 14.3, 95% CI 1.67-122); however, this appeared to be related to HIV co-infection. TB was not associated with an increased risk of other ICBIs. In fact, fewer C. trachomatis infections occurred after recent TB diagnosis. Reasons for this association, including reduced exposure, protection conferred by anti-TB drugs or macrophage activation by Mycobacterium tuberculosis infection warrant further investigation.
authors.affiliation: Division of Infectious Diseases,Department of Medicine,Vanderbilt University,Nashville,TN,USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Huaman
authors.affiliation: Division of Infectious Diseases,Department of Medicine,Vanderbilt University,Nashville,TN,USA.
authors.forename: C T
authors.initials: CT
authors.lastname: Fiske
authors.affiliation: Vanderbilt Tuberculosis Center,Vanderbilt University,Nashville,TN,USA.
authors.forename: T F
authors.initials: TF
authors.lastname: Jones
authors.affiliation: Vanderbilt Tuberculosis Center,Vanderbilt University,Nashville,TN,USA.
authors.forename: J
authors.initials: J
authors.lastname: Warkentin
authors.affiliation: Vanderbilt Tuberculosis Center,Vanderbilt University,Nashville,TN,USA.
authors.forename: B E
authors.initials: BE
authors.lastname: Shepherd
authors.affiliation: Tennessee Department of Health,Nashville,TN,USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Ingram
authors.affiliation: Division of Infectious Diseases,Department of Medicine,Vanderbilt University,Nashville,TN,USA.
authors.forename: F
authors.initials: F
authors.lastname: Maruri
authors.affiliation: Division of Infectious Diseases,Department of Medicine,Vanderbilt University,Nashville,TN,USA.
authors.forename: T R
authors.initials: TR
authors.lastname: Sterling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002690:Chlamydia Infections / Q000453:epidemiology*; D002692:Chlamydia trachomatis; D060085:Coinfection / Q000453:epidemiology; D004405:Dysentery, Bacillary / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008089:Listeria monocytogenes; D008088:Listeriosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis; D012307:Risk Factors; D012480:Salmonella Infections / Q000453:epidemiology*; D012760:Shigella; D013714:Tennessee / Q000453:epidemiology; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology*; D015009:Yersinia Infections / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents
keywords: tuberculosis (TB)