Analysis of Clinical Characteristics and Risk Factors for Drug Resistance in Newly-Treated Patients with Pulmonary Tuberculosis Complicated with Chronic Obstructive Pulmonary Disease

Figures & data

Table 1 Comparison of General Conditions Between the Two Groups

Index	Control Group (n=351)	Study Group (n=138)	χ^2/t	P
Age, n (%)			5.918	0.116
22–35	43 (12.25)	7 (5.07)
36–45	112 (31.91)	45 (32.61)
46–69	126 (35.90)	53 (38.41)
70	70 (19.94)	33 (23.91)
Male, n (%)	184 (52.42)	113 (81.88)	36.047	<0.001*
BMI, kg/m^2	22.98±3.29	22.91±3.21	0.213	0.831
Course of tuberculosis, y	17.98±4.29	18.23±4.22	−0.583	0.560
Smoking history, n (%)	17 (4.84)	35 (25.36)	43.886	<0.001*
Respiratory failure, n (%)	6 (1.71)	23 (16.67)	39.723	<0.001*
Cough, n (%)	176 (50.14)	129 (93.48)	79.263	<0.001*
Fever & night sweats, n (%)	211 (60.11)	134 (97.10)	65.226	<0.001*
Chest short breath, n (%)	132 (37.61)	131 (94.93)	130.934	<0.001*
Weak & thin, n (%)	205 (58.40)	133 (96.38)	66.917	<0.001*
Extrapulmonary tuberculosis, n (%)	51 (14.53)	31 (22.46)	4.467	0.035*
Hemoptysis, n (%)	59 (16.81)	35 (25.36)	4.667	0.031*
Chest pain, n (%)	52 (14.81)	33 (23.91)	5.710	0.017*
History of childhood cough, n (%)	29 (8.26)	39 (28.26)	33.091	<0.001*
Tuberculosis exposure history, n (%)	51 (14.53)	69 (50.00)	67.300	<0.001*
Dust exposure history, n (%)	32 (9.12)	41 (29.71)	33.077	<0.001*
Malnutrition, n (%)	21 (5.98)	36 (26.09)	38.878	<0.001*
Delay in TB diagnosis, d	29.87±3.26	39.99±3.31	−30.762	<0.001*
Lung cavity, n (%)	69 (19.66)	78 (56.52)	64.025	<0.001*
Range of lesions, n (%)			0.891	0.641
One lobe	165 (47.01)	67 (48.55)
Two lobes	131 (37.32)	54 (39.13)
More than three lobes	55 (15.67)	17 (12.32)
Level of education, n (%)			0.270	0.966
Junior high school	40 (11.40)	17 (12.32)
High school	122 (34.76)	49 (35.51)
Junior college	95 (27.06)	38 (27.53)
Bachelor degree or higher	94 (26.78)	34 (24.64)

Note: *Compared between two groups with significant difference.

Abbreviation: TB, tuberculosis.

Table 2 Comparison of Commonly Used Anti-Tuberculosis Drug Resistance Between Two Groups

Drug-Resistant Type	Control Group (n=351)	Study Group (n=138)	χ^2/t	P
Single drug resistance
Isoniazid	38 (10.83%)	28 (20.29%)	7.598	0.006
Ethambutol	27 (7.69%)	24 (17.39%)	9.975	0.002
Rifampicin	32 (9.12%)	27 (19.57%)	12.458	<0.001
Rifapentine	21 (5.98%)	29 (21.01%)	24.382	<0.001
Pyrazinamde	19 (5.41%)	26 (18.84%)	21.374	<0.001
Multiple resistant
Isoniazid+Rifampicin	1 (0.28%)	7 (5.07%)	14.109	<0.001
Isoniazid+Rifapentine	0 (0.00%)	3 (2.17%)	7.678	0.006
Isoniazid+Ethambutol	0 (0.00%)	3 (2.17%)	7.678	0.006
Isoniazid+pyrazinamde	1 (0.28%)	6 (4.35%)	11.589	0.001
Rifampicin+pyrazinamde	0 (0.00%)	2 (1.45%)	5.108	0.024
Rifapentine+pyrazinamde	1 (0.28%)	3 (2.17%)	4.357	0.037
Ethambutol+pyrazinamde	0 (0.00%)	2(1.45%)	5.108	0.024
Isoniazid+Rifampicin+Ethambutol	0 (0.00%)	3 (2.17%)	7.678	0.006
Isoniazid+Rifampicin+pyrazinamde	1 (0.28%)	4 (2.90%)	6.686	0.009
Isoniazid+Ethambutol+pyrazinamde	0 (0.00%)	3 (2.17%)	7.678	0.006
Isoniazid+Rifampicin+Ethambutol+pyrazinamde	0 (0.00%)	2 (1.45%)	5.108	0.024
Other	1 (0.28%)	6 (4.35%)	11.589	0.001

Table 3 Univariate Logistic Regression Analysis of Risk Factors for Drug Resistance in Newly-Treated Pulmonary TB Patients with COPD

Index	β	SE	Wald χ^2	P	OR (95% Cl)
Male	1.341	1.031	2.209	0.042	2.421 (1.501–3.928)
Smoking history	1.182	0.711	7.893	0.017	3.321 (1.786–5.653)
Respiratory failure	0.595	0.867	0.463	0.083	0.736 (0.518–2.018)
Cough	0.082	0.087	0.998	0.321	1.087 (0.918–1.276)
Fever & night sweats	1.903	0.109	4.241	6.748	6.748 (2.201–18.932)
Chest short breath	0.065	0.201	0.107	0.738	1.067 (0.711–1.621)
BMI	0.467	0.254	3.187	0.071	1.589 (0.942–2.654)
Extrapulmonary tuberculosis	0.786	0.573	2.463	0.004	2.187 (1.059–3.246)
Hemoptysis	1.156	1.083	1.132	0.281	3.182 (0.398–8.902)
Chest pain	0.056	0.291	0.054	0.831	1.065 (0.573–1.935)
History of childhood cough	1.232	0.629	6.131	0.023	3.529 (1.221–5.098)
Tuberculosis exposure history	0.951	0.871	8.932	0.013	3.211 (1.401–4.897)
Dust exposure history	1.013	0.482	7.132	0.083	4.367 (1.319–6.718)
Malnutrition	−0.091	0.503	10.328	0.031	2.219 (1.512–3.401)
Lung cavity	1.267	0.524	5.712	0.017	3.438 (1.267–9.129)
Delay in TB diagnosis	1.908	0.951	9.781	<0.001	6.098 (4.719–13.487)
Isoniazid	0.778	0.402	3.761	0.055	2.173 (0.994–4.565)
Ethambutol	0.049	0.258	3.219	0.076	1.589 (0.956–2.692)
Rifampicin	0.058	0.023	1.702	0.272	0.991 (0.876–1.234)
Rifapentine	0.163	0.049	1.976	0.119	1.212 (0.976–1.629)
Pyrazinamde	0.918	0.532	3.128	0.082	2.651 (0.987–5.981)
Isoniazid+Rifampicin	0.109	0.289	0.145	0.698	1.119 (0.618–1.998)
Isoniazid+Rifapentine	0.782	0.529	2.218	0.139	2.198 (0.776–6.251)
Isoniazid+Ethambutol	0.648	0.529	1.478	0.219	1.908 (0.671–5.212)
Isoniazid+pyrazinamde	0.276	0.205	1.881	0.325	1.319 (0.954–1.387)
Rifampicin+pyrazinamde	0.261	0.192	1.823	0.402	1.308 (0.951–1.406)
Rifapentine+pyrazinamde	0.192	0.181	1.076	0.504	1.201 (0.967–1.321)
Ethambutol+pyrazinamde	0.261	0.259	0.993	0.329	1.278 (0.776–2.187)
Isoniazid+Rifampicin+Ethambutol	0.449	0.328	1.879	0.167	1.572 (0.845–2.876)
Isoniazid+Rifampicin+pyrazinamde	3.821	2.039	3.428	0.067	12.982 (0.789–23.981)
Isoniazid+Ethambutol+pyrazinamde	0.832	0.355	3.051	0.079	1.257 (0.051–2.918)
Isoniazid+Rifampicin+Ethambutol+pyrazinamde	0.947	0.492	2.431	0.091	3.276 (1.009–4.398)
Other	0.238	0.521	0.239	0.635	1.231 (1.078–3.298)

Abbreviations: COPD, chronic obstructive pulmonary disease; TB, tuberculosis.

Table 4 Multivariate Logistic Regression Analysis of Risk Factors for Anti-TB Drug Resistance in Newly-Treated Pulmonary TB Patients Complicated with COPD

Index	β	SE	Wald χ^2	P	OR (95% Cl)
Male	0.087	0.027	0.816	0.627	1.109 (0.928–1.453)
Smoking history	0.198	0.103	2.498	0.043	1.229 (1.019–2.891)
Extrapulmonary tuberculosis	1.742	0.482	13.198	<0.001	5.219 (2.098–12.136)
History of childhood cough	0.779	0.402	3.818	0.059	2.178 (0.998–4.237)
Tuberculosis exposure history	1.041	0.163	17.572	<0.001	2.769 (1.702–4.289)
Malnutrition	−0.445	0.178	4.198	0.017	1.709 (1.038–2.106)
Lung cave	1.039	0.278	4.379	0.027	2.351 (1.542–5.876)
Delay in TB diagnosis	1.802	0.869	14.398	<0.001	5.679 (4.098–11.298)

Abbreviations: COPD, chronic obstructive pulmonary disease; TB, tuberculosis.