title: The characteristics of patients with mycobacterium tuberculosis blood stream infections in Beijing, China: a retrospective study.
abstract: BACKGROUND
  Published information regarding the clinical characteristics, laboratory findings, and outcomes of patients with Mycobacterium tuberculosis (MTB) blood stream infection (BSI) is limited. We aimed in this study to evaluate the clinical characteristics, laboratory evaluation, and outcomes of patients with MTB BSI.
  
  
  METHODS
  All patients diagnosed with MTB BSI at Peking Union Medical College Hospital between January 2008 and May 2014 were identified by examining the electronic database listing results of all blood cultures. Data on demographics, clinical characteristics, laboratory manifestations, management, and outcomes were abstracted from medical records.
  
  
  RESULTS
  Six thousand nine hundred seventy-four patients had mycobacterial blood cultures during the study period. Of 48 patients (0.7%) with MTB BSI, 26 patients (54%) were considered to be immunocompromised (refers to a person who has a significantly impaired immune system). This was due to human immunodeficiency virus (HIV) infection (n = 2 of 48 tested), receiving steroids (n = 17, including 16 with rheumatic diseases and one with myasthenia gravis), malignancy (n = 3), diabetes mellitus (n = 3), and renal transplantation (n = 1). The main clinical manifestations were fever (100%, with a median of 40 °C), weight loss (48%) and cough with sputum production (46%). Most patients had one or more organs involved (81%). The median time from onset of fever to diagnosis was 8 weeks (IQR 5 ~ 14). Six patients died within 1 week after diagnosis. Of the 17 patients completing treatment, 14 patients (82%) recovered without major complications and they had a shorter time interval between onsets of symptoms to treatment compared to those died of TB.
  
  
  CONCLUSIONS
  In this group of patients with MTB BSI, fever and multiple organs involvement were common, the outcome was poor and timely diagnosis and treatment might favor outcome.
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China. liuxq@pumch.cn.|Clinical Epidemiology Unit, International Epidemiology Network, Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China. liuxq@pumch.cn.
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
authors.forename: Sainan
authors.initials: S
authors.lastname: Bian
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
authors.forename: Yueqiu
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.|Clinical Epidemiology Unit, International Epidemiology Network, Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
authors.forename: Lifan
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Laboratory Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
authors.forename: Qiwen
authors.initials: Q
authors.lastname: Yang
authors.affiliation: Laboratory Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Wang
authors.affiliation: Laboratory Department, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
authors.forename: Yingchun
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
authors.forename: Xiaochun
authors.initials: X
authors.lastname: Shi
authors.affiliation: Clinical Epidemiology Unit, International Epidemiology Network, Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Infectious Diseases, Infection Control, and Employee Health, Unit 1460, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
authors.forename: Roy F
authors.initials: RF
authors.lastname: Chemaly
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D016208:Databases, Factual; D005260:Female; D015658:HIV Infections / Q000150:complications; D006761:Hospitals; D006801:Humans; D016867:Immunocompromised Host; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D055815:Young Adult
keywords: Bacteremia; Blood stream infection; Mycobacterium tuberculosis