Retrospective study of clinical and lesion characteristics of patients undergoing surgical treatment for Pulmonary Tuberculosis in Georgia
Vashakidze, Sergo (National Center for Tuberculosis and Lung Diseases (NCTLD))
Despuig, Albert (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Gogishvili, Shota (National Center for Tuberculosis and Lung Diseases (NCTLD), 50, Maruashvili Str. 0101 Tbilisi, Georgia)
Nikolaishvili, Keti (National Center for Tuberculosis and Lung Diseases (NCTLD), 50, Maruashvili Str. 0101 Tbilisi, Georgia)
Shubladze, Natalia (National Center for Tuberculosis and Lung Diseases (NCTLD), 50, Maruashvili Str. 0101 Tbilisi, Georgia)
Avaliani, Zaza (National Center for Tuberculosis and Lung Diseases (NCTLD), 50, Maruashvili Str. 0101 Tbilisi, Georgia)
Tukvadze, Nestan (National Center for Tuberculosis and Lung Diseases (NCTLD), 50, Maruashvili Str. 0101 Tbilisi, Georgia)
Casals, Martí (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Caylà, Joan A.. (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Cardona, Pere-Joan (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Vilaplana, Cristina (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Date:	2016
Abstract:	Our aim was to retrospectively compare clinical data and characteristics of removed lesions of the cohort of patients undergoing therapeutical surgery for their tuberculosis. Demographic and epidemiological details, clinical data, data on the surgery performed, macroscopic characteristics of the TB lesions removed, and outcome were recorded retrospectively from the 137 patients who underwent therapeutical surgery for their TB in Tbilisi, Georgia during 2014 and 2015. Men represented 70% of the included patients, presented more comorbidities and underwent operation earlier in terms of days between diagnostic and surgery. Women underwent operation at younger ages, and in MDR/XDR-TB cases, showed higher percentages of sputum conversion at >2 months and of fresh necrosis in the surgical specimens, suggesting a worse evolution. Half of cases were MDR/XDR-TB cases. In spite of being considered microbiologically cured according to WHO, a non despricable percentage of cases showed viable bacilli in the surgical specimen. Even if no causality could be statistically demonstrated, differences could be encountered according to gender and drug susceptibility of the responsible strains. According to our results, host factors such as gender, type of necrosis found in the lesions, size of lesions and presence of viable bacilli in the surgical specimen, should be included in future studies on therapeutical surgery of TB. As most of studies are done in MDR/XDR-TB, more data on DS-TB operated cases are needed. Our results also highlight that, in spite of achieving the microbiologically cured status, sterilization might not occur, and thus new biomarkers and new methods to evaluate the healing process of TB patients are urgently needed and radiological assays should be taken into account.
Grants:	Instituto de Salud Carlos III CP13-00174
Note:	Altres ajuts: This work was supported by CIBER Enfermedades Respiratorias (CB06/06/0031); and the SEPAR trough Project 2016/023.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Tuberculosis ; Surgery ; Gender ; DS-TB ; MDR/XDR-TB ; Necrosis
Published in:	International journal of infectious diseases, Vol. 56 (december 2016) , p. 200-207, ISSN 1878-3511

DOI: 10.1016/j.ijid.2016.12.009
PMID: 28007659

19 p, 711.7 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles