Clinical and Computed Tomography Features Associated with Multidrug-Resistant Pulmonary Tuberculosis: A Retrospective Study in China

作者全名："Li, Chun-Hua; Fan, Xiao; Lv, Sheng-Xiu; Liu, Xue-Yan; Wang, Jia-Nan; Li, Yong-Mei; Li, Qi"

作者地址："[Li, Chun-Hua; Liu, Xue-Yan; Li, Yong-Mei; Li, Qi] Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, Chongqing, Peoples R China; [Li, Chun-Hua; Lv, Sheng-Xiu; Liu, Xue-Yan; Wang, Jia-Nan] Chongqing Publ Hlth Med Ctr, Dept Radiol, Chongqing, Peoples R China; [Fan, Xiao] Chongqing Med Univ, Childrens Hosp, Natl Clin Res Ctr Child Hlth & Disorders, Dept Radiol Minist Educ Key Lab Child Dev & Disord, Chongqing, Peoples R China; [Li, Yong-Mei; Li, Qi] Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, 1 Youyi Rd, Chongqing 400016, Peoples R China"

通信作者："Li, YM; Li, Q (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, 1 Youyi Rd, Chongqing 400016, Peoples R China."

来源：INFECTION AND DRUG RESISTANCE

ESI学科分类：IMMUNOLOGY

WOS号：WOS:000938694000001

JCR分区：Q2

影响因子：2.9

年份：2023

卷号：16

期号：　

开始页：651

结束页：659

文献类型：Article

关键词：tuberculosis; multidrug-resistant tuberculosis; computed tomography

摘要："Purpose: To explore the value of integrating clinical and computed tomography (CT) features to predict multidrug-resistant Patients and Methods: The study included 212 patients with MDR-PTB and 180 patients with drug-sensitive pulmonary tuberculosis (DS-PTB) who referred to our institute in China between January 2016 and March 2021. The clinical and CT characteristics were analyzed and compared between both groups. Multivariable logistic regression analysis was performed to identify independent factors that can be used to predict MDR-PTB. Furthermore, 115 patients admitted to another center from January 2019 to January 2022 were included as external validation cohort. Results: For clinical characteristics, five parameters were significantly different between the two groups (all P < 0.05). With regard to CT features, nine parameters were significantly different between the two groups (all P < 0.05). Multivariable logistic regression analysis using the aforementioned differential features showed that male sex, retreated history, longer duration of previous anti-TB treatment, lower CD4+ T lymphocyte count, thick-walled cavity, centrilobular micronodules and tree-in-bud sign, bronchial stenosis, pleural and pericardial thickening were the most effective variations associated with MDR-PTB with an area under the curve (AUC) of 0.849 and accuracy of 78.6%. Furthermore, the external validation cohort that contains 115 patients obtained an AUC of 0.933 and accuracy of 81.7%. Conclusion: MDR-PTB and DS-PTB have different clinical and imaging characteristics. A combined model incorporating these differential features can promptly diagnose MDR-PTB and develop subsequent therapeutic strategies."

基金机构："Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau) [2022MSXM147, 2022MSXM142]; Chongqing Health Commission Foundation [2020jstg027]"

基金资助正文："This study was supported by Chongqing medical scientific research project (Joint project of Chongqing Health Commission and Science and Technology Bureau) (2022MSXM147, 2022MSXM142) and Chongqing Health Commission Foundation (2020jstg027) of China."