Mycobacterium Tuberculosis Bacteremia in Adults and Children: A Systematic Review and Meta-Analysis

Int J Tuberc Lung Dis. 2016 Jul;20(7):895-902. doi: 10.5588/ijtld.15.0773.

Abstract

SETTINGp: Among human immunodeficiency virus (HIV) infected adults living in tuberculosis (TB) endemic settings, Mycobacterium tuberculosis is a common cause of bloodstream infections. Although young children have an increased propensity for M. tuberculosis dissemination, M. tuberculosis bacteremia is infrequently described in children.

Objective: To determine the prevalence of M. tuberculosis bacteremia in adult and pediatric patients and to examine sources of heterogeneity between estimates.

Design: Systematic review and meta-analysis.

Results: Of 1077 reviewed abstracts, 27 publications met the inclusion criteria, yielding 29 independent M. tuberculosis bacteremia prevalence estimates: 22 in adults, 6 in children, and 1 not stratified by age group. The random effects pooled M. tuberculosis bacteremia prevalence in adults was 13.5% (95%CI 10.8-16.2) and 0.4% (95%CI 0-0.9) in children (P for difference = 0.004). Restricting analyses to HIV-infected participants, pooled M. tuberculosis bacteremia prevalence from 21 adult studies was 15.5% (95%CI 12.5-18.5) and 0.8% (95%CI 0-1.8) in three pediatric studies (P = 0.001). Inclusion of pre-determined study-level confounders did not account for observed differences in M. tuberculosis bacteremia prevalence between age groups.

Conclusion: While M. tuberculosis bacteremia appears relatively common in adults, particularly those with HIV infection, bloodstream M. tuberculosis appears to be rare in children.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Bacteremia / diagnosis
  • Bacteremia / epidemiology*
  • Bacteremia / microbiology
  • Child
  • Child, Preschool
  • Coinfection
  • HIV Infections / epidemiology
  • Humans
  • Infant
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification*
  • Prevalence
  • Tuberculosis / diagnosis
  • Tuberculosis / epidemiology*
  • Tuberculosis / microbiology
  • Young Adult