Changes in intestinal flora of newly diagnosed pulmonary tuberculosis patients and their clinical relationship with multidrug resistance
Objective:To observe the changes in intestinal flora of newly diagnosed pulmonary tuberculosis pa-tients and analyze their clinical relationship with multidrug resistance.Methods:A total of 347 newly diagnosed pulmonary tuberculosis patients admitted to our hospital from June 2021 to May 2023 were enrolled in the tuberculo-sis group.Another 347 healthy subjects who underwent physical examination in our hospital during the same period were enrolled in the healthy group.The relative abundance,Observed species indexes and Shannon indexes of the intestinal flora at the genus level were compared between the two groups.Two months after treatment,according to whether mycobacterium tuberculosis(MTB)was multidrug-resistant,the tuberculosis group was divided into multi-drug-resistant group and non-multidrug-resistant group.The general data,relative abundance of the intestinal flora at the genus level were compared between the multidrug-resistant group and the non-multidrug-resistant group.Lo-gistic regression model was used to analyze the influencing factors of multidrug resistance in newly diagnosed pulmo-nary tuberculosis patients.Results:Compared with the healthy group,the relative abundance of butyricomonas,ba-caeroides,lactobacillus,bifidobacterium,blautia,and clostridium,and the Observed species index and Shannon in-dex in the tuberculosis group were decreased(P＜0.05),the relative abundance of enterococcus,coprococcus,dorella,shigella,microbacterium,veillonococcus,ruminococcus were increased(P＜0.05).The multidrug resist-ance rate of newly diagnosed pulmonary tuberculosis patients was 23.08％.Compared with the non-multidrug-re-sistant group,the relative abundance of bifidobacterium,the Observed species index and Shannon index decreased in the multidrug-resistant group(P＜0.05).Logistic regression model analysis showed that primary and secondary education level(OR=2.678,95％CI:1.309-5.476),chronic obstructive pulmonary disease(COPD)(OR=3.931,95％CI:1.514-10.212),history of tuberculosis exposure(OR=2.494,95％CI:1.364-4.562),num-ber of pulmonary tuberculosis cavity lesions(OR=2.776,95％CI:1.872-4.116),treatment interruption(OR=2.450,95％CI:1.306-4.596),relative abundance of bifidobacterium(OR=0.393,95％CI:0.268-0.576)and Shannon index(OR=0.463,95％CI:0.302-0.712)were influencing factors of multidrug resistance in newly diagnosed pulmonary tuberculosis patients(P＜0.05).Conclusion:Newly diagnosed pulmonary tuberculosis pa-tients have intestinal flora imbalance.Primary and secondary education level,COPD,history of tuberculosis expo-sure,number of pulmonary tuberculosis cavity lesions,treatment interruption are risk factors for multidrug resist-ance,while relative abundance of bifidobacterium and Shannon index are protective factors.
万方数据
维普
