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Günther G, Guglielmetti L, Kherabi Y, Duarte R, Lange C, Adamides T, Akkerman O, Andersen AB, Bakos Á, Bjarnason A, Bruchfeld J, Chesov D, Codecasa LR, Cirillo D, Danilovits M, Davidavičienė E, Duarte R, De Souza Galvão ML, Garnier S, Gjocaj M, Günther G, Ibraim E, Kappnik M, Khachatryan N, Klimuk D, Kuksa L, Jachym MF, Josefsdottir K, Kaluzhenina A, Lange C, Mack U, Makek MJ, Manika K, Mclaughlin AM, Mema D, Mengshoel AT, Muylle I, Nanovic Z, Özkara Ş, Perl S, Pesut D, Pierdou D, Ryskulov G, Skowroński M, Solovic I, Sukholytka M, Svetina P, Terleeva Y, Tiberi S, Togonidze T, Torri S, Turaev L, Usmanova R, Wirtz G, Vasankari T, Zhdanova E. Availability of drugs and resistance testing for BPaLM regimen for rifampicin-resistant tuberculosis in Europe. Clin Microbiol Infect 2024:S1198-743X(24)00121-6. [PMID: 38490355 DOI: 10.1016/j.cmi.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/13/2024] [Accepted: 03/05/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVES Multidrug-resistant/Rifampicin-resistant tuberculosis (TB) is a major obstacle to successful TB control. The recommendation by the World Health Organization to use bedaquiline, pretomanid, linezolid and moxifloxacin (BPaL(M)) for 6 months, based on results of three trials with high efficacy and low toxicity, has revolutionized treatment options. METHODS In this study, representatives of the Tuberculosis Network European Trialsgroup (TBnet) in 44/54 countries of the WHO Europe region document the availability of the medicines and drug susceptibility testing (DST) of the BPaL(M) regimen through a structured questionnaire between September to November 2023. RESULTS 24/44 (54.5%), 42/44 (95.5%), 43/44 (97.7%), and 43/44 (97.7%) had access to pretomanid, bedaquiline, linezolid, and moxifloxacin, respectively. Overall, 23/44 (52.3%) had access to all the drugs composing the BPaL(M) regimen. 7/44 (15.9%), 28/44 (63.6%), 34/44 (77.3%) and 36/44 (81.8%) had access to DST for pretomanid, bedaquiline, linezolid and moxifloxacin, respectively. DST was available for all medicines composing the BPaL(M) regimen in 6/44 (13.6%) countries. CONCLUSION Only in about half of the countries participating in the survey clinicians have access to all the BPaL(M) regimen drugs. In less than a fifth of countries, a complete DST is possible. Rapid scale up of DST capacity to prevent unnoticed spread of drug resistance and equal access to new regimens are urgently needed in Europe.
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Affiliation(s)
- Gunar Günther
- Department of Pulmonary Medicine and Allergology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Department of Medical Sciences, School of Medicine, University of Namibia, Windhoek, Namibia
| | - Lorenzo Guglielmetti
- Sorbonne Université, INSERM, U1135, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France; Assistance Publique Hopitaux de Paris, Groupe Hospitalier Universitaire Sorbonne Université, Hopital Pitié-Salpetrière, Centre National de Référence des Mycobactéries etde la Résistance des Mycobactéries aux Antituberculeux, Paris, France
| | - Yousra Kherabi
- Infectious and Tropical Diseases Department, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France; Université Paris Cité, Inserm, IAME, Paris, France
| | - Raquel Duarte
- Unidade de Investigação em Epidemiologia (EPI Unit), Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal; Departamento de Saúde Comunitária, Estudos de Populações, Instituto de Ciências Biomédicas Abel Salazar, ICBAS, Universidade do Porto, Portugal; Serviço de Pneumologia, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal; Unidade de Investigação Clínica, Administração Regional de Saúde do Norte, Porto, Portugal
| | - Christoph Lange
- Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany; German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany; Respiratory Medicine and International Health, University of Lübeck, Lübeck, Germany; Baylor College of Medicine and Texas Children Hospital, Global TB Program, Houston, TX, USA.
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Casco N, Jorge AL, Palmero DJ, Alffenaar JW, Fox GJ, Ezz W, Cho JG, Denholm J, Skrahina A, Solodovnikova V, Arbex MA, Alves T, Rabahi MF, Pereira GR, Sales R, Silva DR, Saffie MM, Salinas NE, Miranda RC, Cisterna C, Concha C, Fernandez I, Villalón C, Vera CG, Tapia PG, Cancino V, Carbonell M, Cruz A, Muñoz E, Muñoz C, Navarro I, Pizarro R, Cristina Sánchez GP, Vergara Riquelme MS, Vilca E, Soto A, Flores X, Garavagno A, Bahamondes MH, Merino LM, Pradenas AM, Revillot ME, Rodriguez P, Salinas AS, Taiba C, Valdés JF, Subiabre JN, Ortega C, Palma S, Castillo PP, Pinto M, Bidegain FR, Venegas M, Yucra E, Li Y, Cruz A, Guelvez B, Victoria Plaza R, Tello Hoyos KY, Cardoso-Landivar J, Van Den Boom M, Andréjak C, Blanc FX, Dourmane S, Froissart A, Izadifar A, Rivière F, Schlemmer F, Manika K, Diallo BD, Hassane-Harouna S, Artiles N, Mejia LA, Gupta N, Ish P, Mishra G, Patel JM, Singla R, Udwadia ZF, Alladio F, Angeli F, Calcagno A, Centis R, Codecasa LR, De Lauretis A, Esposito SMR, Formenti B, Gaviraghi A, Giacomet V, Goletti D, Gualano G, Matteelli A, Migliori GB, Motta I, Palmieri F, Pontali E, Prestileo T, Riccardi N, Saderi L, Saporiti M, Sotgiu G, Spanevello A, Stochino C, Tadolini M, Torre A, Villa S, Visca D, Kurhasani X, Furjani M, Rasheed N, Danila E, Diktanas S, Ridaura RL, Luna López FL, Torrico MM, Rendon A, Akkerman OW, Chizaram O, Al-Abri S, Alyaquobi F, Althohli K, Aguirre S, Teixeira RC, De Egea V, Irala S, Medina A, Sequera G, Sosa N, Vázquez F, Llanos-Tejada FK, Manga S, Villanueva-Villegas R, Araujo D, Sales Marques RD, Socaci A, Barkanova O, Bogorodskaya M, Borisov S, Mariandyshev A, Kaluzhenina A, Vukicevic TA, Stosic M, Beh D, Ng D, Ong CWM, Solovic I, Dheda K, Gina P, Caminero JA, De Souza Galvão ML, Dominguez-Castellano A, García-García JM, Pinargote IM, Fernandez SQ, Sánchez-Montalvá A, Huguet ET, Murguiondo MZ, Bart PA, Mazza-Stalder J, D'Ambrosio L, Kamolwat P, Bakko F, Barnacle J, Bird S, Brown A, Chandran S, Killington K, Man K, Papineni P, Ritchie F, Tiberi S, Utjesanovic N, Zenner D, Hearn JL, Heysell S, Young L. Long-term outcomes of the global tuberculosis and COVID-19 co-infection cohort. Eur Respir J 2023; 62:2300925. [PMID: 37827576 PMCID: PMC10627308 DOI: 10.1183/13993003.00925-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/04/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Longitudinal cohort data of patients with tuberculosis (TB) and coronavirus disease 2019 (COVID-19) are lacking. In our global study, we describe long-term outcomes of patients affected by TB and COVID-19. METHODS We collected data from 174 centres in 31 countries on all patients affected by COVID-19 and TB between 1 March 2020 and 30 September 2022. Patients were followed-up until cure, death or end of cohort time. All patients had TB and COVID-19; for analysis purposes, deaths were attributed to TB, COVID-19 or both. Survival analysis was performed using Cox proportional risk-regression models, and the log-rank test was used to compare survival and mortality attributed to TB, COVID-19 or both. RESULTS Overall, 788 patients with COVID-19 and TB (active or sequelae) were recruited from 31 countries, and 10.8% (n=85) died during the observation period. Survival was significantly lower among patients whose death was attributed to TB and COVID-19 versus those dying because of either TB or COVID-19 alone (p<0.001). Significant adjusted risk factors for TB mortality were higher age (hazard ratio (HR) 1.05, 95% CI 1.03-1.07), HIV infection (HR 2.29, 95% CI 1.02-5.16) and invasive ventilation (HR 4.28, 95% CI 2.34-7.83). For COVID-19 mortality, the adjusted risks were higher age (HR 1.03, 95% CI 1.02-1.04), male sex (HR 2.21, 95% CI 1.24-3.91), oxygen requirement (HR 7.93, 95% CI 3.44-18.26) and invasive ventilation (HR 2.19, 95% CI 1.36-3.53). CONCLUSIONS In our global cohort, death was the outcome in >10% of patients with TB and COVID-19. A range of demographic and clinical predictors are associated with adverse outcomes.
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Casco N, Jorge AL, Palmero D, Alffenaar JW, Fox G, Ezz W, Cho JG, Skrahina A, Solodovnikova V, Bachez P, Arbex MA, Galvão T, Rabahi M, Pereira GR, Sales R, Silva DR, Saffie MM, Miranda RC, Cancino V, Carbonell M, Cisterna C, Concha C, Cruz A, Salinas NE, Revillot ME, Farias J, Fernandez I, Flores X, Gallegos P, Garavagno A, Guajardo C, Bahamondes MH, Merino LM, Muñoz E, Muñoz C, Navarro I, Navarro J, Ortega C, Palma S, Pardenas AM, Pereira G, Castillo PP, Pinto M, Pizarro R, Rivas F, Rodriguez P, Sánchez C, Serrano A, Soto A, Taiba C, Venegas M, Vergara MS, Vilca E, Villalon C, Yucra E, Li Y, Cruz A, Guelvez B, Plaza R, Tello K, Andréjak C, Blanc FX, Dourmane S, Froissart A, Izadifar A, Rivière F, Schlemmer F, Gupta N, Ish P, Mishra G, Sharma S, Singla R, Udwadia ZF, Manika K, Diallo BD, Hassane-Harouna S, Artiles N, Mejia LA, Alladio F, Calcagno A, Centis R, Codecasa LR, D Ambrosio L, Formenti B, Gaviraghi A, Giacomet V, Goletti D, Gualano G, Kuksa L, Danila E, Diktanas S, Miliauskas S, Ridaura RL, López F, Torrico MM, Rendon A, Akkerman OW, Piubello A, Souleymane MB, Aizpurua E, Gonzales R, Jurado J, Loban A, Aguirre S, de Egea V, Irala S, Medina A, Sequera G, Sosa N, Vázquez F, Manga S, Villanueva R, Araujo D, Duarte R, Marques TS, Grecu VI, Socaci A, Barkanova O, Bogorodskaya M, Borisov S, Mariandyshev A, Kaluzhenina A, Stosic M, Beh D, Ng D, Ong C, Solovic I, Dheda D, Gina P, Caminero JA, Cardoso-Landivar J, de Souza Galvão ML, Dominguez-Castellano A, García-García JM, Pinargote IM, Fernandez SQ, Sánchez-Montalvá A, Huguet ET, Murguiondo MZ, Bruchfeld J, Bart PA, Mazza-Stalder J, Tiberi S, Arrieta F, Heysell S, Logsdon J, Young L. TB and COVID-19 co-infection: rationale and aims of a global study. Int J Tuberc Lung Dis 2021; 25:78-80. [PMID: 33384052 DOI: 10.5588/ijtld.20.0786] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
| | | | | | | | - G Fox
- New South Wales, Australia
| | - W Ezz
- New South Wales, Australia
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Villafuerte D, Aliberti S, Soni NJ, Faverio P, Marcos PJ, Wunderink RG, Rodriguez A, Sibila O, Sanz F, Martin‐Loeches I, Menzella F, Reyes LF, Jankovic M, Spielmanns M, Restrepo MI, Aruj PK, Attorri S, Barimboim E, Caeiro JP, Garzón MI, Cambursano VH, Ceccato A, Chertcoff J, Cordon Díaz A, de Vedia L, Ganaha MC, Lambert S, Lopardo G, Luna CM, Malberti AG, Morcillo N, Tartara S, Pensotti C, Pereyra B, Scapellato PG, Stagnaro JP, Shah S, Lötsch F, Thalhammer F, Anseeuw K, Francois CA, Van Braeckel E, Vincent JL, Djimon MZ, Nouér SA, Chipev P, Encheva M, Miteva D, Petkova D, Balkissou AD, Yone EWP, Ngahane BHM, Shen N, Xu JF, Rico CAB, Buitrago R, Paternina FJP, Ntumba JMK, Carevic VV, Jakopovic M, Jankovic M, Matkovic Z, Mitrecic I, Jacobsson MLB, Christensen AB, Heitmann Bødtger UC, Meyer CN, Jensen AV, El-Said Abd El-Wahhab I, Morsy NE, Shafiek H, Sobh E, Abdulsemed KA, Bertrand F, Brun‐Buisson C, Montmollin ED, Fartoukh M, Messika J, Tattevin P, Khoury A, Ebruke B, Dreher M, Kolditz M, Meisinger M, Pletz MW, Hagel S, Rupp J, Schaberg T, Spielmanns M, Creutz P, Suttorp N, Siaw-Lartey B, Dimakou K, Papapetrou D, Tsigou E, Ampazis D, Kaimakamis E, Bhatia M, Dhar R, D'Souza G, Garg R, Koul PA, Mahesh PA, Jayaraj BS, Narayan KV, Udnur HB, Krishnamurthy SB, Kant S, Swarnakar R, Limaye S, Salvi S, Golshani K, Keatings VM, Martin-Loeches I, Maor Y, Strahilevitz J, Battaglia S, Carrabba M, Ceriana P, Confalonieri M, Monforte AD, Prato BD, Rosa MD, Fantini R, Fiorentino G, Gammino MA, Menzella F, Milani G, Nava S, Palmiero G, Petrino R, Gabrielli B, Rossi P, Sorino C, Steinhilber G, Zanforlin A, Franzetti F, Carone M, Patella V, Scarlata S, Comel A, Kurahashi K, Bacha ZA, Ugalde DB, Zuñiga OC, Villegas JF, Medenica M, van de Garde E, Mihsra DR, Shrestha P, Ridgeon E, Awokola BI, Nwankwo ON, Olufunlola AB, Olumide S, Ukwaja KN, Irfan M, Minarowski L, Szymon S, Froes F, Leuschner P, Meireles M, Ravara SB, Brocovschii V, Ion C, Rusu D, Toma C, Chirita D, Dorobat CM, Birkun A, Kaluzhenina A, Almotairi A, Bukhary ZAA, Edathodu J, Fathy A, Enani AMA, Mohamed NE, Memon JU, Bella A, Bogdanović N, Milenkovic B, Pesut D, Borderìas L, Garcia NMB, Cabello Alarcón H, Cilloniz C, Torres A, Diaz-Brito V, Casas X, González AE, Fernández‐Almira ML, Gallego M, Gaspar‐García I, Castillo JGD, Victoria PJ, Laserna Martínez E, Molina RMD, Marcos PJ, Menéndez R, Pando‐Sandoval A, Aymerich CP, Rello J, Moyano S, Sanz F, Sibila O, Rodrigo‐Troyano A, Solé‐Violán J, Uranga A, van Boven JFM, Torra EV, Pujol JA, Feldman C, Yum HK, Fiogbe AA, Yangui F, Bilaceroglu S, Dalar L, Yilmaz U, Bogomolov A, Elahi N, Dhasmana DJ, Feneley A, Hancock C, Hill AT, Rudran B, Ruiz‐Buitrago S, Campbell M, Whitaker P, Youzguin A, Singanayagam A, Allen KS, Brito V, Dietz J, Dysart CE, Kellie SM, Franco‐Sadud RA, Meier G, Gaga M, Holland TL, Bergin SP, Kheir F, Landmeier M, Lois M, Nair GB, Patel H, Reyes K, Rodriguez‐Cintron W, Saito S, Soni NJ, Noda J, Hinojosa CI, Levine SM, Angel LF, Anzueto A, Whitlow KS, Hipskind J, Sukhija K, Totten V, Wunderink RG, Shah RD, Mateyo KJ, Noriega L, Alvarado E, Aman M, Labra L. Prevalence and risk factors for
Enterobacteriaceae
in patients hospitalized with community‐acquired pneumonia. Respirology 2019; 25:543-551. [PMID: 31385399 DOI: 10.1111/resp.13663] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 07/11/2019] [Accepted: 07/15/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Enterobacteriaceae (EB) spp. family is known to include potentially multidrug-resistant (MDR) microorganisms, and remains as an important cause of community-acquired pneumonia (CAP) associated with high mortality. The aim of this study was to determine the prevalence and specific risk factors associated with EB and MDR-EB in a cohort of hospitalized adults with CAP. METHODS We performed a multinational, point-prevalence study of adult patients hospitalized with CAP. MDR-EB was defined when ≥3 antimicrobial classes were identified as non-susceptible. Risk factors assessment was also performed for patients with EB and MDR-EB infection. RESULTS Of the 3193 patients enrolled with CAP, 197 (6%) had a positive culture with EB. Fifty-one percent (n = 100) of EB were resistant to at least one antibiotic and 19% (n = 38) had MDR-EB. The most commonly EB identified were Klebsiella pneumoniae (n = 111, 56%) and Escherichia coli (n = 56, 28%). The risk factors that were independently associated with EB CAP were male gender, severe CAP, underweight (body mass index (BMI) < 18.5) and prior extended-spectrum beta-lactamase (ESBL) infection. Additionally, prior ESBL infection, being underweight, cardiovascular diseases and hospitalization in the last 12 months were independently associated with MDR-EB CAP. CONCLUSION This study of adults hospitalized with CAP found a prevalence of EB of 6% and MDR-EB of 1.2%, respectively. The presence of specific risk factors, such as prior ESBL infection and being underweight, should raise the clinical suspicion for EB and MDR-EB in patients hospitalized with CAP.
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Affiliation(s)
- David Villafuerte
- Division of Pulmonary Diseases and Critical Care MedicineUniversity of Texas Health – San Antonio San Antonio TX USA
- Division of Pulmonary Diseases and Critical Care MedicineSouth Texas Veterans Health Care System San Antonio TX USA
| | - Stefano Aliberti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoRespiratory Unit and Cystic Fibrosis Adult Center Milan Italy
- Department of Pathophysiology and TransplantationUniversity of Milan Milan Italy
| | - Nilam J. Soni
- Division of Pulmonary Diseases and Critical Care MedicineUniversity of Texas Health – San Antonio San Antonio TX USA
- Division of Pulmonary Diseases and Critical Care MedicineSouth Texas Veterans Health Care System San Antonio TX USA
| | - Paola Faverio
- Cardio‐Thoracic‐Vascular Department, University of Milan Bicocca, Respiratory UnitSan Gerardo Hospital, ASST di Monza Monza Italy
| | - Pedro J. Marcos
- Servicio de Neumología, Instituto de Investigación Biomédica de A Coruña (INIBIC)Complejo Hospitalario Universitario de A Coruña (CHUAC) Sergas Universidade da Coruña (UDC) A Coruña Spain
| | - Richard G. Wunderink
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Feinberg School of MedicineNorthwestern University Chicago IL USA
| | - Alejandro Rodriguez
- Hospital Universitari Joan XXIII, Critical Care MedicineRovira and Virgili University and CIBERes (Biomedical Research Network of Respiratory Disease) Tarragona Spain
| | - Oriol Sibila
- Servei de Pneumologia, Departamento de Medicina, Hospital Santa Creu i Sant PauUniversitat Autònoma de Barcelona Barcelona Spain
| | - Francisco Sanz
- Pulmonology DepartmentConsorci Hospital General Universitari de Valencia Valencia Spain
| | | | - Francesco Menzella
- Department of Cardiac‐Thoracic‐Vascular and Intensive Care Medicine, Pneumology UnitIRCCS – Arcispedale Santa Maria Nuova Reggio Emilia Italy
| | - Luis F. Reyes
- Department of MicrobiologyUniversidad de la Sabana Bogota Colombia
| | - Mateja Jankovic
- School of Medicine, Clinic for Respiratory DiseasesUniversity Hospital Center Zagreb, University of Zagreb Zagreb Croatia
| | - Marc Spielmanns
- Internal Medicine Department, Pulmonary Rehabilitation and Department of Health, School of MedicineUniversity Witten‐Herdecke, St. Remigius‐Hospital Leverkusen Germany
| | - Marcos I. Restrepo
- Division of Pulmonary Diseases and Critical Care MedicineUniversity of Texas Health – San Antonio San Antonio TX USA
- Division of Pulmonary Diseases and Critical Care MedicineSouth Texas Veterans Health Care System San Antonio TX USA
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Sane Schepisi M, Navarra A, Altet Gomez MN, Dudnyk A, Dyrhol-Riise AM, Esteban J, Giorgetti PF, Gualano G, Guglielmetti L, Heyckendorf J, Kaluzhenina A, Lange B, Lange C, Manika K, Miah J, Nanovic Z, Pontali E, Prego MR, Solovic I, Tiberi S, Palmieri F, Girardi E. Burden and Characteristics of the Comorbidity Tuberculosis-Diabetes in Europe: TBnet Prevalence Survey and Case-Control Study. Open Forum Infect Dis 2018; 6:ofy337. [PMID: 30697572 PMCID: PMC6330516 DOI: 10.1093/ofid/ofy337] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 12/14/2018] [Indexed: 11/14/2022] Open
Abstract
Background The growing burden of diabetes mellitus (DM) is posing a threat to global tuberculosis (TB) control. DM triples the risk of developing TB, modifies the presenting features of pulmonary TB, and worsens TB treatment outcomes. We aimed to analyze the prevalence of DM among TB patients and to describe the characteristics and clinical presentation of TB-DM patients in Europe. Methods We performed a cross-sectional survey on the prevalence of DM among consecutively diagnosed adult TB patients in 11 European TB referral centers located in France, Germany, Greece, Italy, Russia, Slovakia, Spain, and the United Kingdom over the period 2007–2015. We also selected DM-TB cases and TB only controls with a 1:3 ratio to perform a case-control analysis, including patients selected from the countries mentioned above plus Norway and Ukraine. Results Among 3143 TB enrolled patients, DM prevalence overall was 10.7% and ranged from 4.4% in Greece to 28.5% in the United Kingdom. Patients’ median ages ranged from 36 to 49 years, and all centers had >60% males; the proportion of foreign-born patients varied widely across sites. In the case-control study, DM was independently associated with older age and, among older patients, with being foreign-born. Among patients with pulmonary involvement, cavities on chest imaging were more frequently observed among those with DM. Conclusions Diabetes mellitus represents a challenge for TB control in Europe, especially in foreign-born and in elderly patients. Specific screening strategies should be evaluated.
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Affiliation(s)
- Monica Sane Schepisi
- Clinical Epidemiology Unit, National Institute for Infectious Diseases L. Spallanzani - IRCCS, Rome, Italy
| | - Assunta Navarra
- Clinical Epidemiology Unit, National Institute for Infectious Diseases L. Spallanzani - IRCCS, Rome, Italy
| | - M Nieves Altet Gomez
- Unidad de Tratamiento Directamente Observado de la Tuberculosis "Servicios Clínicos," Barcelona, Spain
| | - Andrii Dudnyk
- Tuberculosis, Clinical Immunology & Allergy Department, National Pirogov Memorial Medical University, Vinnytsia, Ukraine
| | - Anne Margarita Dyrhol-Riise
- Department of Infectious Diseases, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Department of Clinical Science, University of Bergen, Norway
| | - Jaime Esteban
- Departamento de Microbiología Clínica, Fundación Jiménez Díaz, Madrid, Spain
| | - Pier Francesco Giorgetti
- Clinica di Malattie Infettive e Tropicali, A. O. Spedali Civili di Brescia e Università di Brescia, Brescia, Italy
| | - Gina Gualano
- Clinical Department, National Institute for Infectious Diseases L. Spallanzani - IRCCS, Rome, Italy
| | - Lorenzo Guglielmetti
- Sanatorium, Centre Hospitalier de Bligny Briis-sous-Forges, Paris, France.,APHP, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux (CNR-MyRMA), Bactériologie-Hygiène, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Paris, France.,Sorbonne Université, Unité 1135, Team E13 (Bactériologie), CR7 INSERM, Centre d'Immunologie et des Maladies Infectieuses, Paris, France
| | - Jan Heyckendorf
- Research Center Borstel. German Center for Infection Research (DZIF), Borstel, Germany
| | - Anna Kaluzhenina
- Department of Phthisiopulmonology, Volgograd State Medical University, Volgograd, Russian Federation
| | - Berit Lange
- Infectious Disease Division, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.,Center for Chronic Immunodeficiency, Faculty of Medicine, Medical Center, University of Freiburg, Germany
| | - Christoph Lange
- Research Center Borstel. German Center for Infection Research (DZIF), Borstel, Germany
| | - Katerina Manika
- Respiratory Infections Unit, Pulmonary Department, Aristotle University of Thessaloniki, "G. Papanikolaou" Hospital, Thessaloniki, Greece
| | - Jalal Miah
- Division of Infection, Barts Health NHS Trust, London, United Kingdom
| | - Zorica Nanovic
- Institute of Lung Diseases and Tuberculosis - Skopje, Institute of Lung Diseases and Tuberculosis - Skopje, Skopje, FYROM (Macedonia)
| | - Emanuele Pontali
- Divisione di Malattie Infettive, Ospedale Galliera - Genova, Genova, Italy
| | - Monica Rios Prego
- Enfermedades Infecciosas, Medicina Interna, Complexo Hospitalario Universitario de Pontevedra, Pontevedra, Spain
| | | | - Simon Tiberi
- Division of Infection, Barts Health NHS Trust, London, United Kingdom
| | - Fabrizio Palmieri
- Clinical Department, National Institute for Infectious Diseases L. Spallanzani - IRCCS, Rome, Italy
| | - Enrico Girardi
- Clinical Epidemiology Unit, National Institute for Infectious Diseases L. Spallanzani - IRCCS, Rome, Italy
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