Multidrug-Resistant Tuberculosis in Patients with Chronic Obstructive Pulmonary Disease in China.
BACKGROUND
Relatively little is known about the specific relationship and impact from chronic obstructive pulmonary disease (COPD) on multidrug-resistant tuberculsosis (MDR-TB).


METHODS
We conducted a retrospective study included patients aged ≥40 years with a confirmed pulmonary TB at three tertiary hospitals (Shandong, China) between January 2011 and October 2014. Univariable and multivariable analyses were performed to identify the relationship of MDR-TB and COPD.


RESULTS
A total of 2164 patients aged ≥ 40 years with available results of drug susceptibility test (DST) and medical records were screened for this study: 268 patients with discharge diagnosis of COPD and 1896 patients without COPD. Overall, 14.2% of patients with COPD and 8.5% patients without COPD were MDR-TB. The rate of MDR-TB were significantly higher in patients with COPD (P<0.05). Migrant (odds ratios (OR) 1.32, 95% confidence interval (CI) 1.02-1.72), previous anti-TB treatment (OR 4.58, 95% CI 1.69-12.42), cavity (OR 2.33, 95% CI 1.14-4.75), and GOLD stage (OR 1.86, 95% CI 1.01-2.93) were the independent predictors for MDR-TB among patients with COPD.


CONCLUSIONS
MDR-TB occurs more frequently in patients with underlying COPD, especially those with being migrant, previous anti-TB therapy, cavity and severe airway obstruction.
Department of Respiratory Medicine, Provincial Hospital Affiliated to Shandong University, Jinan, China.
Jiang-Nan
JN
Zhao
Department of Respiratory Medicine, Shandong Provincial Chest Hospital, Jinan, China.
Xian-Xin
XX
Zhang
Department of Respiratory Medicine, Provincial Hospital Affiliated to Shandong University, Jinan, China.
Xiao-Chun
XC
He
Department of Respiratory Medicine, Chest Specially Hospital of Weifang, Weifang, China.
Guo-Ru
GR
Yang
Department of Tuberculosis Medicine, Chest Specially Hospital of Weifang, Weifang, China.
Xiao-Qi
XQ
Zhang
Department of Tuberculosis Medicine, Chest Specially Hospital of Weifang, Weifang, China.
Wen-Gen
WG
Xin
Department of Respiratory Medicine, Provincial Hospital Affiliated to Shandong University, Jinan, China.
Huai-Chen
HC
Li
D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000150:complications* / Q000453:epidemiology*