title: The Relationship between Extensively Drug-Resistant Tuberculosis and Multidrug-Resistant Gram-Negative Bacilli.
abstract: OBJECTIVE
  The relationship between extensively drug-resistant tuberculosis (XDR-TB) and multidrug-resistant Gram-negative bacilli (MDR-GNB) is unclear. Identification of the relationship between XDR-TB and MDR-GNB would have important implications for patient care.
  
  
  METHODS
  We conducted a retrospective study reviewing the records of patients admitted with a confirmed pulmonary TB from 2011 to 2014. To identify the relationship between XDR-TB and MDR-GNB, univariable comparison and multivariable logistic regression were performed.
  
  
  RESULTS
  Among 2962 pulmonary TB patients, 45(1.5%) patients had a diagnosis of XDR-TB. A total of 165 MDR-GNB strains were detected in 143 (4.8%) pulmonary TB patients. XDR-TB patients had a significantly higher occurrence of MDR-GNB than non-XDR-TB patients (24.4% vs. 4.5%; P<0.001). Age (OR 1.02, 95% CI 1.01-1.03), hypoalbuminemia (OR 1.48, 95% CI 1.18-1.85), chronic renal failure (OR 6.67, 95% CI 1.42-31.47), chronic hepatic insufficiency (OR 1.99, 95% CI 1.15-3.43), presence of XDR-TB (OR 6.56, 95% CI 1.61-26.69), and duration of TB diagnostic delay (OR 1.01, 95% CI 1.00-1.02) were the independent risk factors for MDR-GNB infection.
  
  
  CONCLUSIONS
  Patients with XDR-TB have a significantly higher risk of being affected by MDR-GNB pathogen. The underlying mechanism association warrant further studies.
authors.affiliation: Department of Respiratory Medicine, Provincial Hospital Affiliated to Shandong University, Jinan, China.
authors.forename: Jiang-Nan
authors.initials: JN
authors.lastname: Zhao
authors.affiliation: Department of Respiratory Medicine, Shandong Provincial Chest Hospital, Jinan, China.
authors.forename: Xian-Xin
authors.initials: XX
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine, Provincial Hospital Affiliated to Shandong University, Jinan, China.
authors.forename: Xiao-Chun
authors.initials: XC
authors.lastname: He
authors.affiliation: Department of Respiratory Medicine, Chest Specially Hospital of Weifang, Weifang, China.
authors.forename: Guo-Ru
authors.initials: GR
authors.lastname: Yang
authors.affiliation: Department of Tuberculosis Medicine, Chest Specially Hospital of Weifang, Weifang, China.
authors.forename: Xiao-Qi
authors.initials: XQ
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Medicine, Provincial Hospital Affiliated to Shandong University, Jinan, China.
authors.forename: Huai-Chen
authors.initials: HC
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D012189:Retrospective Studies; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000382:microbiology