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Factores de riesgo de positividad de esputo en pacientes con EPOC diagnosticados por primera vez de tuberculosis
Daoyan Tang1, Jing Yang2, Yongxian Zhang2
1Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China; State Key Laboratory of Respiratory Health and Multimorbidity, China.
Microbial pathogenesis
|January 27, 2026
Resumen
En pacientes con enfermedad pulmonar obstructiva crónica (EPOC) y tuberculosis activa, el consumo de alcohol, el bajo índice de masa corporal (IMC), la baja albúmina y el recuento elevado de neutrófilos son indicadores clave de positividad del esputo. Los médicos deben considerar el examen de esputo para estos pacientes.
Área de la Ciencia:
- Neumología
- Enfermedades Infecciosas
- Medicina Clínica
Sus antecedentes:
- La enfermedad pulmonar obstructiva crónica (EPOC) y la tuberculosis (TB) activa son desafíos importantes para la salud mundial.
- La coinfección con EPOC y TB activa presenta complejidades únicas en el diagnóstico y el manejo.
Objetivo del estudio:
- Identificar los factores de riesgo clínicos asociados con la positividad del esputo para bacilos ácido-alcohol resistentes (BAAR) en pacientes diagnosticados con EPOC y TB activa.
- Ayudar en el diagnóstico temprano y el manejo apropiado de los pacientes en esta población coinfectada.
Principales métodos:
- Análisis retrospectivo de 776 pacientes con EPOC y TB activa coexistentes.
- Comparación de datos de referencia, recuentos sanguíneos e índices bioquímicos entre los grupos con esputo positivo y negativo para bacilos ácido-alcohol resistentes (BAAR).
- Análisis de regresión logística para determinar los factores de riesgo independientes de positividad del esputo para bacilos ácido-alcohol resistentes (BAAR).
Principales resultados:
- Los pacientes con esputo positivo para bacilos ácido-alcohol resistentes (BAAR) tenían un menor índice de masa corporal (IMC), menor nivel de albúmina y mayor recuento de neutrófilos en comparación con los pacientes con esputo negativo para BAAR.
- El historial de consumo de alcohol se asoció significativamente con la positividad del esputo para BAAR.
- Se observó un menor riesgo de positividad del esputo para BAAR en pacientes con enfermedad renal crónica y enfermedad cardiovascular.
Conclusiones:
- El bajo índice de masa corporal (IMC), el consumo de alcohol, la baja albúmina sérica y el recuento elevado de neutrófilos son factores de riesgo significativos para la positividad del esputo para bacilos ácido-alcohol resistentes (BAAR) en pacientes con EPOC y TB activa.
- Estos factores de riesgo identificados justifican una mayor sospecha clínica y un examen de esputo rápido.
- Se recomienda la consideración del aislamiento respiratorio según la evaluación individual del paciente.
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