Rifampin resistance and diabetes mellitus in a cross-sectional study of adult patients in rural South India
Abstract
Background
Despite increasing
reports of the linkage between diabetes and tuberculosis (TB),
there is limited information regarding diabetes and TB drug
resistance.
Methods
In this cross-sectional
study, sputum and blood samples were collected from 304 adult
patients in rural Andhra Pradesh. Rifampin resistance was
assessed by Xpert MTB/RIF (Xpert), and diabetes status was based
on self-report. Additionally, samples were assayed by acid-fast
bacilli sputum smear microscopy (AFB) and QuantiFERON-TB Gold
In-Tube (QFT-G), in order to compare relative diagnostic
performances.
Results
Among patients with
confirmed TB (n = 194), diabetes was associated
with 3.0-fold higher risk of rifampin resistance (95 % CI
1.3–6.7). Considering Xpert MTB/RIF the gold standard, AFB
had lower sensitivity (72.2 vs. 82.5 %) and higher specificity
(96.4 vs. 37.0 %) compared to QFT-G for diagnosing TB.
Conclusions
The increased risk of
rifampin resistance in patients with diabetes highlights the
need for integrated diabetes surveillance in TB programs,
particularly in settings undergoing the epidemiological
transition.
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Source:
BMC Infectious Diseases
