Blood cultures for the diagnosis of multidrug-resistant and extensively drug-resistant tuberculosis among HIV-infected patients from rural South Africa: a cross-sectional study

BMC Infect Dis. 2010 Dec 6;10:344. doi: 10.1186/1471-2334-10-344.

Abstract

Background: The yield of mycobacterial blood cultures for multidrug-resistant (MDR) and extensively drug-resistant tuberculosis (XDR-TB) among drug-resistant TB suspects has not been described.

Methods: We performed a retrospective, cross-sectional analysis to determine the yield of mycobacterial blood cultures for MDR-TB and XDR-TB among patients suspected of drug-resistant TB from rural South Africa. Secondary outcomes included risk factors of Mycobacterium tuberculosis bacteremia and the additive yield of mycobacterial blood cultures compared to sputum culture.

Results: From 9/1/2006 to 12/31/2008, 130 patients suspected of drug-resistant TB were evaluated with mycobacterial blood culture. Each patient had a single mycobacterial blood culture with 41 (32%) positive for M. tuberculosis, of which 20 (49%) were XDR-TB and 8 (20%) were MDR-TB. One hundred fourteen (88%) patients were known to be HIV-infected. Patients on antiretroviral therapy were significantly less likely to have a positive blood culture for M. tuberculosis (p = 0.002). The diagnosis of MDR or XDR-TB was made by blood culture alone in 12 patients.

Conclusions: Mycobacterial blood cultures provided an additive yield for diagnosis of drug-resistant TB in patients with HIV from rural South Africa. The use of mycobacterial blood cultures should be considered in all patients suspected of drug-resistant TB in similar settings.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / blood
  • AIDS-Related Opportunistic Infections / complications
  • AIDS-Related Opportunistic Infections / microbiology*
  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Extensively Drug-Resistant Tuberculosis / blood*
  • Extensively Drug-Resistant Tuberculosis / complications
  • Extensively Drug-Resistant Tuberculosis / epidemiology
  • Female
  • HIV Infections / blood
  • HIV Infections / complications
  • HIV Infections / microbiology*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification*
  • Retrospective Studies
  • Risk Factors
  • Rural Population
  • South Africa / epidemiology
  • Sputum / microbiology
  • Young Adult