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Updated: Feb 16, 2026
A Tuberculosis Molecular Bacterial Load Assay TB-MBLA
Published on: April 30, 2020
Bacterial co-infection and early mortality among pulmonary tuberculosis patients in Manila, The Philippines
T Shimazaki1, T Taniguchi1, N R D Saludar2
1Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
Insights
Bacterial co-infections are common in HIV-negative pulmonary tuberculosis patients. These co-infections significantly increase the risk of early death in this vulnerable population.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Pulmonary tuberculosis (PTB) remains a significant global health challenge.
- Bacterial co-infections can complicate PTB management and impact patient outcomes.
- Understanding co-infection prevalence in human immunodeficiency virus (HIV)-negative PTB patients is crucial for targeted interventions.
Purpose of the Study:
- To determine the prevalence of bacterial co-infection in hospitalized HIV-negative PTB patients.
- To assess the impact of bacterial co-infection on early mortality within this patient group.
- To investigate potential differences in co-infection prevalence between TB-PCR-positive and TB-PCR-negative individuals.
Main Methods:
- A prospective observational study design was employed.
- HIV-negative PTB patients were enrolled from a national infectious disease hospital.
- Sputum samples were analyzed using polymerase chain reaction (PCR) for Mycobacterium tuberculosis and common bacterial pathogens.
Main Results:
- Nearly half (48.9%) of patients tested positive for TB via PCR.
- Bacterial pathogens were detected in 29.0% of patients, with Haemophilus influenzae and Streptococcus pneumoniae being most frequent.
- Bacterial co-infection was significantly associated with a higher risk of 2-week mortality in TB-PCR-positive patients.
Conclusions:
- Bacterial co-infection is a frequent occurrence in HIV-negative PTB patients.
- Bacterial co-infection is a significant contributing factor to early mortality in this population.
- Early detection and management of bacterial co-infections are vital for improving outcomes in PTB patients.
Objective:
To investigate the prevalence of bacterial co-infection and its effect on early mortality among hospitalised human immunodeficiency virus (HIV) negative pulmonary tuberculosis (PTB) patients in Manila, the Philippines.
Design:
A prospective observational study was conducted at a national infectious disease hospital. HIV-negative PTB patients aged 13 years hospitalised from November to December 2011 and from December 2012 to May 2013 were enrolled. Sputum samples were tested for Mycobacterium tuberculosis and six respiratory bacterial pathogens using polymerase chain reaction (PCR).
Results:
Of 466 patients, 228 (48.9%) were TB-PCR-positive. Overall, bacterial pathogens in purulent sputum were detected in 135 (29.0%) patients: Haemophilus influenzae was the most common bacterium (21.2%), followed by Streptococcus pneumoniae (7.9%). The prevalence of bacterial co-infection did not differ between TB-PCR-positive and -negative patients. A total of 92 (19.7%) patients died within 2 weeks. Bacterial co-infection was significantly associated with an increased risk of 2-week mortality among TB-PCR-positive patients (adjusted risk ratio [aRR] 1.67, 95%CI 1.03-2.72). This association was also observed but did not reach statistical significance among TB-PCR-negative patients (aRR1.7, 95%CI 0.95-3.02).
Conclusion:
Bacterial co-infection is common and contributes to an increased risk of early mortality among HIV-negative PTB patients.
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