BACKGROUND: Research on pregnant patients with rifampicin-resistant tuberculosis remains limited. This study aims to retrospectively analyze the clinical characteristics and outcomes of pregnant patients with rifampicin-resistant tuberculosis, providing valuable insights for the management and treatment of such cases. METHODS: This retrospective study reviewed the electronic medical records of pregnant patients with rifampicin-resistant tuberculosis admitted to the Public Health Clinical Center of Chengdu between July 2017 and April 2025. The clinical characteristics and outcomes of these patients were analyzed. RESULTS: A total of 21 pregnant patients with rifampicin-resistant tuberculosis were included in the study, with a mean age of 28.8 years. Among them, 14 patients (66.7%) had no prior history of tuberculosis treatment, and 18 patients (85.7%) conceived naturally. The majority (90.5%) were carrying a singleton pregnancy. Regarding treatment outcomes (referring to maternal tuberculosis treatment outcomes), 11 patients (52.4%) were cured, 8 patients (38.1%) completed treatment, and 2 patients (9.5%) died. Adverse reactions occurred in 12 patients (57.1%) during treatment. Pregnancy outcomes (two twins) included 6 live births (26.1%), 5 miscarriages (21.7%), 1 died (4.3%) and 11 pregnancy terminations (47.8%). CONCLUSION: The findings suggest that pregnant patients with rifampicin-resistant tuberculosis can achieve favorable maternal treatment outcomes with appropriate treatment. However, nearly half of the patients (52.4%) opted for pregnancy termination.

Abstract Background The diagnosis of active tuberculosis (ATB) in children and adolescents remains challenging due to the non-specific clinical presentation, paucibacillary infection, and limitations of current diagnostic methods. This study aimed to evaluate the association of the logarithmic platelet-to-lymphocyte ratio (logPLR) with ATB in children and adolescents. Methods A retrospective study was conducted involving 1,080 children and adolescents, including 904 in the ATB group and 176 in the non-TB group. A logistic regression model was used to assess the association between logPLR and ATB infection, adjusting for multiple confounding factors (age, sex, ethnicity, residence, Bacillus Calmette–Guérin (BCG) vaccination status, tuberculin skin test (TST) result, Mycobacterium tuberculosis (MTB) exposure history, and CD4 + /CD8 + T-cell counts). Restricted cubic spline (RCS) analyses were applied to examine potential non-linear relationships of logPLR and ATB infection, and subgroup analyses were performed to evaluate the stability of the association across different populations. Receiver operating characteristic (ROC) curves were generated for logPLR in discriminating ATB from non-TB groups. In addition, the diagnostic efficacy of logPLR was compared with Xpert MTB/RIF Ultra assay. Results After adjusting for confounding factors, logPLR showed a significant positive association with ATB infection (OR = 2.08, 95% CI 1.36–3.18, P = 0.001). RCS curve revealed a linear relationship between logPLR and ATB infection (non-linear P = 0.16), with logPLR values higher than 5.259 indicating increased infection of ATB. ROC analysis showed that the AUC of logPLR for discriminating ATB from non-TB was 0.658, and 0.704 for etiologically confirmed TB (E-TB) from non-TB. When compared with Xpert MTB/RIF Ultra, logPLR demonstrated comparable sensitivity (42.3% vs. 44.1%) and a higher positivity rate (38.1% vs. 36.0%). Subgroup analyses confirmed consistent positive associations across all demographic and clinical subgroups, including immunocompromised patients with low CD4 + /CD8 + T-cell counts. Conclusions The results of this study showed that logPLR is a simple, cost-effective, and stable biomarker for diagnosing ATB in children and adolescents. Its linear relationship with ATB infection and consistent performance across diverse subgroups support its broad clinical applicability. Future prospective multicenter studies should validate these findings and explore the integration of logPLR with other biomarkers to improve diagnostic accuracy. Graphical Abstract

BackgroundActive tuberculosis (ATB) in children and adolescents remains a major diagnostic challenge. Inflammation, nutrition, and immune status are closely linked to tuberculosis (TB) progression. We therefore proposed a novel biomarker, the logarithmic lymphocyte-albumin product (logLAP), integrating immune and nutritional indicators, and investigated its association with ATB in children and adolescents.MethodsThis retrospective study included 1,080 participants aged <18 years. Participants were classified into ATB (n = 904) and non-TB (n = 176) groups. LAP was calculated as lymphocyte × albumin, and logLAP was derived as log(LAP). Discriminatory ability was evaluated using receiver operating characteristic (ROC) curves. Logistic regression models were applied to assess the association between logLAP and ATB. Restricted cubic spline (RCS) analyses and stratified analyses were conducted to explore nonlinear relationships and subgroup differences.ResultsCompared with non-TB controls, ATB patients exhibited significantly lower logLAP levels (4.07 ± 0.55 vs. 4.39 ± 0.47, p < 0.001). In ROC analysis, LAP achieved the higher area under the curve (AUC = 0.6955) than neutrophil-lymphocyte ratio (NLR), neutrophil-albumin ratio (NAR), platelet-lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and prognostic-nutritional index (PNI). The clinical diagnostic cut-off value for logLAP was 4.23, with a sensitivity of 60% and a specificity of 74%. Logistic regression models revealed the third tertile (Q3) of logLAP showed a strong inverse association with ATB (OR = 0.33, 95% CI: 0.18–0.59, p < 0.001) after full adjustment. RCS analyses with four knots revealed a significant non-linear relationship between logLAP and ATB (p for non-linearity = 0.021), confirming a threshold effect at logLAP = 3.48. Stratified analyses indicated consistent associations across most subgroups, while logLAP showed limited associations in children aged 0–7 years and those with severe immune dysfunction (CD4+/CD8+ T cell counts below the reference range). The AUC of logLAP demonstrated a clear advantage over traditional biomarkers; however, its diagnostic performance remained relatively limited. This suggests that logLAP is more suitable as a supplementary tool and should be used in conjunction with other clinical or laboratory indicators.ConclusionAs a biomarker integrating immune-nutritional status, logLAP exhibits a robust inverse association with ATB infection in children and adolescents aged ≥8 years with normal or moderately impaired immune function, supported by comprehensive analyses.

Pulmonary cavitation is a characteristic feature of severe tuberculosis (TB) that substantially influences both disease transmission and clinical outcomes. Although immunonutritional imbalances have been implicated in the pathogenesis of TB, the role of composite biomarkers, such as the neutrophil-to-albumin ratio (NAR), in pediatric populations has not been extensively investigated. This study sought to assess the association between NAR and pulmonary cavitation in children and adolescents with active pulmonary tuberculosis (PTB), as well as to identify potential effect modifiers. A retrospective cohort study was undertaken involving 880 pediatric and adolescent patients (aged under 18 years) with microbiologically or clinically confirmed ATB, who were admitted to the Public Health Clinical Center of Chengdu from April 2022 to December 2024. Patients with HIV, comorbidities, or incomplete data were excluded from the study. The NAR was calculated using baseline complete blood count and serum albumin levels, and was subsequently log-transformed (lgNAR) for analytical purposes. Multivariable logistic regression models were employed to evaluate the association between lgNAR and pulmonary cavitation, with adjustments for age, gender, Bacillus Calmette-Guérin (BCG) vaccination status, tuberculin skin test (TST) results, history of exposure, previous tuberculosis history, and CD4 + and CD8 + T-cell counts. Subgroup analyses and restricted cubic spline (RCS) analyses were conducted to assess effect modification and dose–response relationships, respectively. Pulmonary cavitation was observed in 197 (22.4

Background:The diagnosis of active tuberculosis (ATB) in children and adolescents is limited by non-specific symptoms, paucibacillary infection, and the low sensitivity of traditional tools. These limitations can lead to delayed treatment and increased complications. Methods:This retrospective study recruited 1,080 participants. We performed receiver operating characteristic (ROC) curves to evaluate the diagnostic performance of logarithmic neutrophil-to-lymphocyte ratio (logNLR) for ATB infection. We employed logistic regression, restricted cubic spline (RCS), stratified, and interaction analyses to evaluate the association between logNLR and ATB infection. Results:The logNLR was significantly associated with ATB infection in the adjusted model (OR = 1.38, 95% CI: 1.01-1.88, P = 0.044). The RCS curve indicated a non-linear relationship between logNLR and ATB infection, with the critical threshold of 0.9232. The breakpoint analyses further confirmed that when logNLR<1.379, the indicator logNLR was positively correlated with ATB infection. Stratified analyses showed logNLR was a reliable predictor in males, 0-7 and 15-17 years old, those with Mycobacterium tuberculosis (MTB) exposure, and participants with CD4+ T cell counts>414 cells/μL or CD8+ T cell counts>238 cells/μL (all P<0.05). Interaction analyses revealed that children with both CD4+ T cell counts ≤414 cells/μL and MTB exposure had a substantially higher ATB risk (OR = 19.31). Similarly, synergies were observed in combinations of CD4+ T cell counts ≤414 cells/μL with 0-14 years old, and MTB exposure with 0-14 years old. Conclusions:The logNLR is a simple, low-cost, and effective biomarker for diagnosis of ATB in children and adolescents. The critical threshold and breakpoint of logNLR enable precise risk stratification, providing valuable support for early ATB identification in this population.

Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis (Mtb). Despite significant advancements in anti-tuberculosis treatment strategies in recent years, TB remains a major infectious disease threat worldwide. Chronic Mtb infection drives T cell exhaustion-characterized by upregulated co-inhibitory receptors-which correlates with TB chronicity, treatment failure, and relapse. Immune checkpoint inhibitors (ICIs) targeting co-inhibitory receptors have achieved groundbreaking progress in the treatment of various malignancies. However, their application in the field of tuberculosis remains controversial. This study provides a comprehensive analysis of TB disease assessment and treatment from the perspective of T cell exhaustion. We investigate the correlation between co-inhibitory receptor expression levels and both disease activity and progression. Furthermore, we analyze the dual impact of targeting these receptors on anti-TB immunity: While blockade of co-inhibitory receptors in T cell exhaustion states restores anti-tuberculosis immunity, excessive inhibition-particularly in hyperimmune conditions-induces detrimental hyperinflammation, exacerbating tissue damage and disrupting immune homeostasis, ultimately worsening clinical outcomes. To address this duality, we emphasize the necessity of personalized immunotherapy strategies based on individual immune profiling, alongside developing novel co-inhibitory receptor blockers and immune modulatory vaccines. This review presents a novel perspective on the application of targeting co-inhibitory receptors in tuberculosis treatment, which will advance the development and application of immunotherapy.

Mitophagy serves as a cytoprotective mechanism that is essential for eliminating dysfunctional or superfluous mitochondria, thereby fine-tuning mitochondrial quantity and maintaining cellular homeostasis. Recent studies underscore the critical role of mitophagy in determining the fate and function of host cells infected by Mycobacterium tuberculosis. The successful pathogen strategically integrates into the host's mitochondrial network, manipulating processes such as apoptosis, metabolic reprogramming, mitochondrial fusion and fission, and reactive oxygen species production. Therefore, understanding those mechanisms is critical for the advancements of host-directed therapies against tuberculosis. This study offers a comprehensive overview of the interplay between Mycobacterium tuberculosis and mitophagy, emphasizing the associated signaling pathways and potential therapeutic targets involved in mitophagy in Mycobacterium tuberculosis infection. Activating mitophagy in infected host cells represents a promising avenue for improving therapeutic outcomes against tuberculosis. This review aims to summarize potential research direction for agents targeting induction of mitophagy. Notably, evidence suggests that BNIP3/NIX-mediated mitophagy may serve as a potential therapeutic target.

Disseminated non-tuberculous mycobacteria (NTM) disease, which is mainly found in immunocompromised individuals, is a rare and severe infection whose diagnosis poses a challenge to clinicians. We present a patient with disseminated NTM infection mistaken for metastatic malignancy in an otherwise healthy patient and the tortuous diagnostic process. Metagenomic next-generation sequencing (mNGS) played a critical role in the diagnosis. Further screening for anti-interferon-γ antibodies revealed that the patient had a potential immunodeficiency.

Type 2 diabetes (T2DM) co-existing with pulmonary tuberculosis (PTB) is associated with increased rates of treatment failure and mortality. Therefore, greater understanding of the occurrence and prevalence of this comorbidity and research to address the prevention and treatment of PTB in patients with T2DM (PTB + T2DM) have become paramount. Weighted gene co-expression network analysis (WGCNA) and Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were employed to identify key gene modules and functions related to PTB + T2DM. Immune cell infiltration and drug sensitivity were compared between PTB + T2DM patients and healthy controls (HCs), with a bioinformatic approach. Several key genes were chosen for in vitro expression assays using quantitative real-time PCR (qRT-PCR), western blotting (WB), and enzyme-linked immunosorbent assay (ELISA). Compared to HCs and T2DM-only patients, PTB + 2DM patients showed upregulated expression of complement component C1q. WGCNA identified five crucial genes associated with PTB + T2DM: C1QA, CD248, LINC00278, MMP8, and MMP9. Multiscale embedded gene co-expression network analysis further identified FN1. The main KEGG pathways in PTB + T2DM patients were related to extracellular matrix-receptor interaction, the interleukin-17 signaling pathway, the AGE-RAGE signaling pathway in diabetic complications, the PI3K-Akt signaling pathway, and neutrophil extracellular trap formation. Receiver operating characteristic (ROC) analysis indicated that CD248, MMP8, MMP9, LINC00278, and C1QA have potential as diagnostic markers for PTB + T2DM. The expression levels of C1QA, LINC00278, MMP8, and MMP9 were significantly higher, and that of CD248 was significantly lower, in PTB + T2DM patients than in HCs. A network comprising highly correlated hub genes and microRNAs revealed the following interactions: C1QA with hsa-miR-363-5p, hsa-miR-671-5p, and hsa-miR-25-5p; CD248 with COL1 A2, COL1 A1, and COL4 A1; MMP8 with hsa-miR-539-5p, MMP9, and CEACAM8; and MMP9 with FN1, MMP8, hsa-miR-29b-3p, hsa-miR-942-3p, hsa-miR-302-5p, and hsa-miR-133a-5p. Seven drugs (ERK_440_1713, JAK_8517_1739, Palbociclib_1054, PLX.4720_1036, Savolitinib_1936, Selumetinib_1736, and VX.11e_2096) exhibited significant sensitivity in patients with high-expression or low-expression of C1QA. ELISA, qRT-PCR, and WB analyses confirmed the upregulated expression of C1QA, MMP8, and MMP9 in the peripheral blood of PTB + T2DM patients. This study elucidated the intricate molecular connections between PTB and T2DM and identified potential shared targets. Five genes (C1QA, MMP8, MMP9, CD248, and LINC00278) have potential as diagnostic markers for PTB + T2DM, and three genes (C1QA, MMP8, and MMP9) were upregulated in the peripheral blood of PTB + T2DM patients. Our findings may serve as a valuable reference for future research and clinical applications.

We sought to assess the factors influencing QTc interval prolongation in patients with multidrug- or rifampicin-resistant tuberculosis. We conducted a retrospective cohort study of admissions with multidrug-resistant or rifampicin-resistant tuberculosis as the primary diagnosis from nine regions in China between May 2018 and June 2020. Guided by directed acyclic graphs, we developed two multivariable logistic regression models to account for identified confounders and examine their impact on outcomes across different aspects. Results were represented as odds ratios with 95

Background: Extrapulmonary tuberculosis (EPTB) is a significant health problem which can lead to severe morbidity and mortality. In clinical practice, EPTB can have a variety of nonspecific clinical manifestations and can be concurrent with other types of EPTB. As information pertaining to concurrent EPTB is scarce, research efforts are needed to find concurrent EPTB types and to explore the association networks and rules of concurrent EPTB. Materials and Methods: An observational multicenter study was carried out at 21 hospitals from 15 provinces in China from Jan 1, 2011, to Dec 31, 2017. All the adult EPTB inpatients (≥ 15 years) were included. Multivariable logistic regression analysis was used to examine the associations of gender and age group for concurrent EPTB. The association network and rules for concurrent EPTB were analyzed by the Apriori algorithm. Results: A total of 75,993 adult EPTB inpatients (not including EPTB concurrent with PTB) were included. The ratio of male:female was 1.32. The most common types of EPTB lesions were tuberculous pleurisy (46.47%). In the fully adjusted multivariable logistic regression models, it was found that female EPTB patients (aOR = 1.129, 95% CI: 1.081-1.178) were more likely to have concurrent EPTB. As age increased, the risk of concurrent EPTB decreased (aOR < 1, p value for trend < 0.001). The association network graph showed that almost all the EPTB diseases may be concurrent with other types of EPTB. Ureteric tuberculosis and sacral tuberculosis diseases existed mainly in concurrence with other types of EPTB (about 80%). Tuberculous pleurisy and tuberculous lymphadenitis of the neck could be concurrent with more than 60 other types of EPTB disease. The most common concurrent EPTB types were tuberculous peritonitis concurrent with tuberculous pleurisy (1.64%). Sacral tuberculosis concurrentwith lumbar vertebra tuberculosis had the highest confidence value (68.56%). The strongest association rule was found for vesical tuberculosis concurrent with ureteric tuberculosis (lift = 166.18) and ureteric tuberculosis concurrent with vesical tuberculosis (lift = 166.18). Conclusion: The present study revealed the occurrence of concurrent EPTB types and analyzed the association network and rules among adult EPTB for the first time in a large sample population. Clinicians should be alert to the incidence of concurrent EPTB and that these patients require administration of customized treatment regimens in order to achieve the best outcomes.

Comorbidities are a significant factor affecting the prognosis of patients with rifampicin-resistant tuberculosis (RR-TB). We evaluated the prevalence of comorbidities and their prognostic effects in a Chinese RR-TB cohort. In this study, we reviewed the clinical data of RR-TB patients who started anti-tuberculosis treatment in China between May 2018 and April 2020 by conducting a multicenter cohort study. A log-binomial regression model was used to analyze the relationship between comorbidities and the treatment outcomes of RR-TB. The burden of comorbidities among RR-TB patients in China was heavy, with 49.45% (670/1355) experiencing at least one comorbidity. The most common comorbidities were diabetes (17.79%), followed by other respiratory diseases (11.14%), other liver and kidney diseases (5.31%), hypertension (5.24%), immunodeficiency (4.94%), viral hepatitis or carriers (3.91%), severe heart disease (2.58%), tumours (1.11%), and chronic kidney disease or renal insufficiency (0.74%). Diabetes (RR = 1.31), severe heart disease (RR = 1.70), tumours (RR = 1.89), hypertension (RR = 1.28), aged ≥ 60 years (RR = 1.64) and 45-59 years (RR = 1.38), ethnic minorities (RR = 1.58), retreatment cases (RR = 1.34), and those not using the bedaquiline regimen (RR = 1.92) significantly increased the risk of unfavorable treatment outcomes. While higher education or above (RR = 0.49), employment (RR = 0.51), and having a normal (R = 0.53) or overweight (R = 0.56) BMI could reduce the risk of unfavorable treatment outcomes. Patients with RR-TB beared a substantial comorbidity burden in China. Notably, the presence of comorbidities such as diabetes, severe cardiac disorders, tumours, and hypertension markedly elevate the risk of adverse treatment outcomes in these patients. It is necessary to strengthen the screening and management of comorbidities to optimize the treatment strategies.

Background:Rifampicin-resistant tuberculosis (RR-TB) is a major global public health challenge. Household close contacts (HHCs) of RR-TB patients face a high risk of Mycobacterium tuberculosis infection. Southwestern China carries a heavy RR-TB burden, yet research data on the infection status of this population remain scarce. This study aimed to evaluate the incidence of latent tuberculosis infection (LTBI) and active tuberculosis disease (TBD) and their associated factors among HHCs of RR-TB patients in this region through active screening, providing data support for optimizing regional RR-TB prevention and control strategies. Methods:Using a cross-sectional design, HHCs of RR-TB patients diagnosed at Chengdu Public Health Clinical Medical Center from October 1, 2023, to March 30, 2025, were enrolled. Clinical data were collected via a self-designed questionnaire including gender, age, body mass index (BMI), relationship to index case, living environment, chronic comorbidities, medication history, and TBD-suspicious symptom screening. TBD screening used chest digital radiography (DR) or computed tomography (CT). Clinical data of index cases were extracted from the hospital information system (HIS), covering sputum acid-fast bacillus smear, sputum mycobacterial culture, sputum molecular testing for M. tuberculosis, fluoroquinolone resistance, extent of pulmonary lesions, and cavitation status. TB infection screening employed tuberculin skin test (TST), ESAT6-CFP10 fusion protein skin test (EC), or interferon-γ release assays (IGRA). Infection status was categorized as uninfected, LTBI, or TBD based on screening results, clinical symptoms, and imaging findings. Incidence rates of LTBI and TBD were calculated. Chi-square tests compared clinical characteristics across infection states. Multivariable logistic regression analyzed factors associated with LTBI and TBD (versus uninfected). Results:264 HHCs from 197 RR-TB index cases were included: 113 males (42.8 %), 151 females (57.2 %), aged 3-78 years (mean 42.4 ± 15.1). Among 209 participants tested with TST: 117 (44.3 %) had induration diameter [0, 5) mm, 17 (6.4 %) [5, 10) mm, 30 (11.4 %) [10, 15) mm, 45 (17.1 %) ≥ 15 mm. Among 46 EC-tested: 29 (11.0 %) had [0, 5) mm, 17 (6.4 %) ≥ 5 mm. Among 9 IGRA-tested: 1 (0.4 %) negative, 8 (3.0 %) positive. After cluster-effect adjustment, LTBI incidence was 31.2 % (95 % confidence interval [CI]: 25.8-38.3), TBD incidence 9.9 % (95 % CI: 6.4-13.6). The proportion of spousal relationships to index cases was higher in LTBI/TBD groups than uninfected (P < 0.05). BMI < 18.5 kg/m2 and positive TBD symptom screening were more frequent in TBD than uninfected/LTBI groups (P < 0.05). Pulmonary cavitation in index cases was more common in TBD contacts (P < 0.05). Multivariable analysis showed spousal relationship was an independent associated factor for LTBI (adjusted odds ratio [aOR] = 2.102, 95 % CI = 1.201-3.677; P = 0.009). Factors associated with TBD included: spousal relationship (aOR = 3.949, 95 % CI = 1.553-10.042; P = 0.004), positive TBD symptoms (aOR = 41.988, 95 % CI = 4.270-412.886; P = 0.001), and pulmonary cavitation in index case (aOR = 2.881, 95 % CI = 1.103-7.523; P = 0.031). Conclusion:High LTBI and TBD rates exist among RR-TB HHCs in this region. Spousal relationship is a risk factor for both LTBI and TBD; positive TBD symptoms and pulmonary cavitation in index cases correlate with TBD. Active screening for RR-TB HHCs and risk-stratified control strategies are recommended to block transmission chains.

BACKGROUND:The pathogenic mechanism of mycobacterium tuberculosis (Mtb) is complex, and the immune mechanism of the host against Mtb infection and the escape mechanism of Mtb are not fully understood. This study aimed to explore the mechanisms underlying complement C1q and Mtb immune escape. METHODS:Functional experiments, using RAW264.7 cells as the focus cell line and applying CCK-8, western blotting, qRT-PCR, and flow cytometry, were carried out to uncover the exact role of C1q in macrophages, glycolytic activation, immune escape, and Mtb. RESULTS:C1q promoted the proliferation of RAW264.7, suppressed cell apoptosis, and regulated the secretion of M1/M2 type molecular markers in RAW264.7 cells. Moreover, C1q induced glycolytic activation in macrophages, and the immune escape of Mtb in the macrophages was accompanied by the activation of glycolysis. CONCLUSION:Complement C1q inhibited the immune escape of Mtb associated with macrophage inflammation and glycolytic activation.

Rifampicin-resistant tuberculosis (RR-TB) remains a significant global public health concern. The elderly population is not only at high risk and among the primary victims of RR-TB but also plays a crucial role in the transmission chain of RR-TB. Their biological particularities, treatment complexities, and social vulnerabilities collectively present substantial challenges to global tuberculosis control. This study aimed to evaluate treatment outcomes and identify predictors of unfavorable outcomes among elderly patients with RR-TB in China. A multicenter retrospective cohort study was conducted, including 248 elderly RR-TB patients treated across eight tertiary hospitals in China from May 2018 to April 2020. Multivariate logistic regression and Propensity Score Matching (PSM) analyses were performed to identify factors associated with unfavorable outcomes. Statistical analyses were performed using SPSS. Among 248 patients, 65.7

Tuberculosis (TB) and human immunodeficiency virus (HIV) infection are infectious diseases that pose serious threats to human health. TB and HIV can interact to promote the progression of diseases. This study aims to provide basic evidence for the formulation of disease prevention and control strategies. A retrospective study was conducted to analyze the characteristics of demographics and comorbidity, in an attempt to identify factors associated with HIV and TB coinfection among TB inpatients at Public Health Clinical Center of Chengdu, China from January 2018 to December 2022. Among 37,587 TB inpatients, HIV-positive and HIV-negative TB cases accounted for 6.1

BACKGROUND:Tuberculosis (TB) is one of the most severe complications following organ and tissue transplantation. Early detection and prompt initiation of anti-TB therapy are therefore essential to reduce mortality among transplant recipients. METHODS:A retrospective cohort analysis was conducted involving 42 transplant recipients who developed new-onset or recurrent TB following solid organ transplantation (SOT) or hematopoietic stem cell transplantation (HSCT) between January 1, 2017, and February 28, 2025. The objective of this study was to investigate the clinical characteristics and prognosis of TB, as well as risk factors associated with severe TB among SOT and HSCT recipients. RESULTS:Among the 42 transplant recipients included in this study, the median time from SOT or HSCT to the onset of new or recurrent TB was 24 months (interquartile range [IQR]: 0.5-180 months). The median time from the symptom onset to TB diagnosis was 26 days (IQR: 1-180 days). The clinical types of TB comprised secondary pulmonary TB (36 cases, 85.71 %), disseminated TB (14 cases, 33.33 %), hematogenous disseminated pulmonary TB (7 cases, 16.67 %), and extrapulmonary TB (19 cases, 45.24 %). Co-infections were detected in 17 TB patients (40.48 %). Severe TB accounted for 28.58 % of all cases. Hypoproteinemia (OR = 0.532, 95 % CI 0.302-0.937; P = 0.029), co-infections (OR = 44.00, 95 % CI 4.712-410.855; P = 0.001), and early post-transplant onset of TB (OR = 0.963, 95 % CI 0.930-0.988; P = 0.036) were identified as independent risk factors for severe TB. The overall treatment success rate for TB was 57.14 %. The 6-month and 12-month overall survival rates were 85.7 % and 78.6 %, respectively. CONCLUSION:Our findings indicate that TB may occur at any time following SOT or HSCT, and often affects extrapulmonary sites. Severe TB is relatively common and frequently associated with co-infections, which contribute to increased mortality. Clinically, these results underscore the importance of regular TB screening of transplant recipients.

This study aimed to conduct a combined detection of Mycobacterium tuberculosis (MTB) infection using the tuberculosis (TB)-specific cytokine interferon-γ (IFN-γ) and interleukin-2 (IL-2) release assays in hospitalized children and adolescents with TB, evaluate the clinical value of this technique in the diagnosis of active TB in children and adolescents, and to analyze the related influencing factors. A retrospective study was conducted to collect data from suspected pediatric and adolescent TB patients hospitalized at Chengdu Public Health Clinical Medical Center between April 2022 and December 2024. The combined detection of MTB infection using IFN-γ and IL-2 release assays (referred to as “dual-factor detection of TB infection”) was carried out. Microbiological or molecular biological test results of MTB were also obtained. A total of 904 patients diagnosed with TB and 176 non-TB patients were included in the analysis of the effectiveness of dual-factor TB infection testing and related influencing factors. The combined detection of IFN-γ and/or IL-2 demonstrated improved diagnostic performance for active tuberculosis (ATB), with a sensitivity of 91.04

Pulmonary cavities in patients with tuberculosis contribute to antibiotic failure, transmission, morbidity, and mortality. We aimed to report the treatment outcomes and risk factors for cavity closure in cavitary multidrug-resistant/rifampicin-resistant tuberculosis in Southwest China. This study was a retrospective cohort study which included adult patients with multidrug-resistant /rifampicin-resistant tuberculosis in Southwest China from January 2018 to January 2023. The patients were categorized into cavity and non-cavity groups, and their clinical characteristics and treatment outcomes were retrospectively compared. A logistic regression model was used to identify potential risk factors associated with cavity closure. In this study, 305 patients were enrolled, with 223 cases in the cavity group and 82 cases in the non-cavity group. The median age of patients in the cavity group was 31 (24, 44) years, with a male to female sex ratio of 155/68. Within the cavity group, 8.1% of patients had rifampicin-resistant tuberculosis, 49.8% had multidrug-resistant tuberculosis, and 42.2% had pre-extensively-drug resistant tuberculosis. The treatment outcomes of the cavitary group showed that 48.9% of patients were cured, 28.3% completed treatment, 14.8% were lost to follow-up, and 6.7% could not be evaluated, with one failure and two deaths. Various factors such as male gender, smoking, drinking, tuberculosis treatment history, baseline AFB smear, bilateral disease, and specific symptoms were more prevalent in the cavity group compared to the non-cavity group. Sputum culture conversion rates at 2 and 6 months were lower in the cavity group (25.6% vs 37.8%; 63.7% vs 79.3% ,all P < 0.05). Within patients with cavities, 40.6% experienced cavity closure after treatment, with a median closure time of 9.00 months. Baseline CD3+ T cell counts decreased was found to be an independent risk factor for cavity closure (aOR = 2.278, 95% CI 1.109-4.680, P = 0.025), while the use of a bedaquiline-containing regimen (aOR = 0.305, 95% CI 0.140-0.663, P = 0.003) and a delamanid-containing regimen (aOR = 0.260, 95% CI 0.086-0.785, P = 0.017) were protective factors. Cavities may influence the timing of culture conversion rather than influencing the treatment outcomes in patients with MDR/RR-TB. The use of bedaquiline and delamanid in treatment regimens for MDR/RR-TB patients could promote cavity closure and may enhance the management of cavitary MDR/RR-TB. Furthermore, the enhancement of immunotherapy could potentially contribute to reducing the burden of cavitary MDR/RR-TB.

Tuberculosis (TB) diagnostic monitoring is paramount to clinical decision-making and the host biomarkers appears to play a significant role. The currently available diagnostic technology for TB detection is inadequate. In the present study, we aimed to identify biomarkers for diagnosis of pulmonary tuberculosis (PTB) using urinary metabolomic and proteomic analysis. Methods: In the study, urine from 40 PTB, 40 lung cancer (LCA), 40 community-acquired pneumonia (CAP) patients and 40 healthy controls (HC) was collected. Biomarker panels were selected based on random forest (RF) analysis. Results: A total of 3,868 proteins and 1,272 annotated metabolic features were detected using pairwise comparisons. Using AUC ≥ 0.80 as a cutoff value, we picked up five protein biomarkers for PTB diagnosis. The five-protein panel yielded an AUC for PTB/HC, PTB/CAP and PTB/LCA of 0.9840, 0.9680 and 0.9310, respectively. Additionally, five metabolism biomarkers were selected for differential diagnosis purpose. By employment of the five-metabolism panel, we could differentiate PTB/HC at an AUC of 0.9940, PTB/CAP of 0.8920, and PTB/LCA of 0.8570. Conclusion: Our data demonstrate that metabolomic and proteomic analysis can identify a novel urine biomarker panel to diagnose PTB with high sensitivity and specificity. The receiver operating characteristic curve analysis showed that it is possible to perform non-invasive clinical diagnoses of PTB through these urine biomarkers.