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Zhilin Liang,1,* Weiming Liao,2,* Qifu Chen,3 Hui Li,1 Meiling Ye,1 Jin Zou,4 Guofang Deng,1 Peize Zhang1 1Department of Pulmonary Medicine & Tuberculosis, The Third People’s Hospital of Shenzhen, National Clinical Research Center for Infectious Disease, Southern University of Science and Technology, Shenzhen, People’s Republic of China; 2Department of Thoracic Oncology, Jiangxi Provincial Cancer Hospital, Nanchang, People’s Republic of China; 3Department of Neurosurgery, The Third People’s Hospital of Shenzhen, National Clinical Research Center for Infectious Disease, Southern University of Science and Technology, Shenzhen, People’s Republic of China; 4Department of Clinical Laboratory, The Third People’s Hospital of Shenzhen, National Clinical Research Center for Infectious Disease, Southern University of Science and Technology, Shenzhen, People’s Republic of China*These authors contributed equally to this workCorrespondence: Peize Zhang; Guofang Deng, Tel +8613509650204 ; +8613530027001, Email 82880246@qq.com; jxxk1035@yeah.netAbstract: Drug-resistant tuberculous meningitis (TBM) is the most devastating and critical form of extrapulmonary tuberculosis. Here, we present a case of a 45-year-old male with pre-extensive drug-resistant tuberculosis meningitis (pre-XDR-TBM). He underwent emergency surgery for the long-tunneled external ventricular drainage (LTEVD). Molecular test and phenotypic drug sensitivity test (DST) of Mycobacterium tuberculosis in cerebrospinal fluid (CSF) showed that the isolate was resistant to both rifampin and fluoroquinolones. An anti-tuberculous regimen of isoniazid, pyrazinamide, cycloserine, moxifloxacin, clofazimine, and linezolid was tailored accordingly. We monitored the drug concentration in his plasma and CSF before (at 0-hour) and after anti-TB drugs administration (at 1-hour, 2-hour, 6-hour, and 12-hour) on 10th day after treatment initiation. We hope to provide reference values of drug ex

Peize Zhang,1,2 Wei Li,3 Miaona Liu,3 Senlin Zhan,2 Hailin Zhang,2 Guofang Deng,2 Xiaoyou Chen1 1Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, People’s Republic of China; 2Department of Pulmonary Medicine and Tuberculosis, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 3Department of Pharmacy, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of ChinaCorrespondence: Guofang Deng; Xiaoyou Chen, Email jxxk1035@yeah.net; chenxy1998@hotmail.comObjective: Linezolid is one of the key drugs for the treatment of multidrug-resistant/extensively drug-resistant tuberculosis (MDR/XDR-TB). We aimed to describe the incorporation of the Michigan Neuropathy Screening Instrument (MNSI) and serum trough concentration as screening tools for neurotoxicity in the management of MDR/XDR-TB patients receiving a linezolid-based treatment regimen in Shenzhen, China.Methods: A total of 73 patients on a linezolid-containing anti–MDR/XDR-TB regimen were prospectively enrolled. The MNSI was used for peripheral neuropathy screening. Optic neuropathy was diagnosed by ophthalmologists. Serum trough concentration was recorded and its relationship with neuropathy analyzed.Results: Of all patients, neuropathy was observed in 40% (29) during anti-TB treatment. Of these, 20 (69%) had peripheral neuritis, seven (24%) optic neuritis, and two (7%) both. Serum trough concentration > 2 mg/L was observed in 17 (59%) patients with neuropathy and 13 (30%) patients without neuropathy. There was a significant statistical difference between the two groups (P=0.013). Time to onset of neuropathy from initiation of the linezolid-containing regimen was within 2 months for eight (28%) patients, 2– 6 months for 18 (62%) patients, and > 6 months for three (10%) patients. Sixteen (55%) patients were adjusted to a lower dose of 300 mg linezolid daily. Four (14%) patients had linezolid permanently removed from their re

Youli Jiang,1,* Lan Luo,2,3,* Min Gui,1 Linlin Liu,1 Yi Lin,2,3 Guofang Deng,2,3 Jingfang Chen,1,3 Peize Zhang2,3 1Hengyang Medical School, School of Nursing, University of South China, Hengyang, People’s Republic of China; 2Department of Pulmonary Medicine and Tuberculosis, The Third People’s Hospital of Shenzhen, Shenzhen, People’s Republic of China; 3National Clinical Research Center for Infectious Diseases, The Third People’s Hospital of Shenzhen, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jingfang Chen; Peize Zhang, Email 13823139640@163.com; 82880246@qq.comBackground: Early diagnosis and timely treatment of tuberculosis are critical for disease control and management. However, diagnostic delay remains severe around the world. We aim to evaluate the duration and factors associated with diagnostic delay of tuberculosis in Shenzhen, China.Methods: We conducted a face-to-face interview to collect the whole care-seeking process of patients diagnosed with active TB in Shenzhen, China, from April 1 to September 30, 2021. The duration from symptom onset to confirmed diagnosis was recorded. The risk factors of diagnostic delay were identified by binary stepwise logistic regression analysis.Results: Among 288 confirmed TB cases, 170 (59.0%) were delayed diagnosis. The median diagnostic delay was 39.5 days. Median patient delay was 23 days and health system delay was 7 days. Income ≤ 315USD/month (OR = 2.97 [95% CI: 1.15– 7.69]), cough (OR = 3.00 [95% CI: 1.16– 7.76]), weight loss (OR = 15.59 [95% CI: 1.85– 131.56]), use of traditional Chinese Medicine (OR = 5.03 [95% CI: 1.04– 24.31]) and over-the-counter cough syrup (OR = 2.73 [95% CI: 1.10– 6.76]) were significant risk factors for patient delay. Fever (OR = 0.13[95% CI: 0.04– 0.48]) and hemoptysis (OR = 0.06 [95% CI0.01– 0.30]) were p

Senlin Zhan,1,&ast; Xiong Juan,2,&ast; Tantan Ren,1 Yuxiang Wang,1 Liang Fu,1 Guofang Deng,1 Peize Zhang1 1Department of Pulmonary Medicine and Tuberculosis, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 2School of Public Health, Health Science Center, Shenzhen University, Shenzhen, Guangdong, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Guofang Deng; Peize Zhang, Email jxxk1035@yeah.net; 82880246@qq.comBackground: Diabetes mellitus (DM) is believed to affect tuberculosis (TB) at multiple levels in disease control and treatment efficacy, but clinical and radiological presentation resulting from interaction of the two diseases is not known.Methods: A cross-sectional study was conducted on data obtained from medical records of 438 patients confirmed with TB-DM comorbidity at the Third people’s hospital of Shenzhen from May 01, 2014, to April 30, 2019. Their CT images were reviewed, and patients were divided into subgroups according to lung cavitation: with and without cavities, and number of segments showing pulmonary infiltration: < 4 segment, 4– 8 segment, > 8 segment infiltrates. We then compared clinical parameters between these groups.Results: The median age of the patients was 50.0 years (IQR 43.3– 56.0) and 86% (n=375) of them were male. Pulmonary cavities were found in 80.8% patients. About 42.7% and 27.2% patients were seen to have infiltration involving 4– 8 and > 8 lung segments, respectively. Patients presented with cavitation and infiltration involving a greater number of lung segments had significantly higher values of WBC, MONO%, GRA%, CRP, lower LYN% level and higher bacterial burden in sputum (P< 0.001). Higher HbA1c and FBG were only observed in patients with lung cavities (P< 0.001). There was no difference in positive ELISPOT.TB and PCT level between the groups regardless of presence or absence of lung cavity (P> 0

Peize Zhang,1,&ast; HouMing Liu,2,&ast; Hui Wang,3,&ast; Yanbo Wu,4 Liqin Sun,3 Man Rao,3 Xinyun Jia,3 Ying Song,3 Guofang Deng,1 Tianpin Li,2 Feidi Ye,2 Yang Zhou,3 Yi Liao5 1Department of Lung Disease, The Third People’s Hospital of Shenzhen, Shenzhen City, Guangdong Province, People’s Republic of China; 2Department of Clinical Laboratory, The Third People’s Hospital of Shenzhen, Shenzhen City, Guangdong Province, People’s Republic of China; 3Department of Infectious Disease No.1, The Third People’s Hospital of Shenzhen, Shenzhen City, Guangdong Province, People’s Republic of China; 4Department of Infectious Disease, Shenzhen Longhua New District Central Hospital, Shenzhen City, Guangdong Province, People’s Republic of China; 5Department of Primary Health Promotion, Shenzhen Center for Disease Control and Prevention, Shenzhen City, Guangdong Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yang Zhou; Yi Liao Email yangzhou@szsy.sustech.edu.cn; ly_jht@126.comBackground: Sputum is commonly used for the diagnostic testing of pulmonary tuberculosis (PTB), but people living with HIV/AIDS (PLWHA) usually have little sputum. Moreover, the automated molecular test, Xpert MTB/RIF assay (Xpert), has a low sensitivity in PLWHA. We aimed to estimate the performance of Xpert Ultra on the detection of Mycobacterium tuberculosis (MTB) using bronchoalveolar lavage (BAL).Methods: From February 5, 2018 to March 30, 2019, a total of 99 PLWHA with suspected PTB at the Third People’s Hospital of Shenzhen, China, were recruited. The information on demographics and medical history, blood MTB antigen-specific interferon gamma enzyme-linked immunospot assay (T-SPOT.TB), T lymphocyte subsets, and plasma HIV RNA load were collected. Computed tomography (CT) and flexible bronchoscopy were performed, and BAL and blood samples were collected. Testing of acid-fast bacilli (AFB), tuberculosis real-time fluore

Peize Zhang,1,* Juan Xiong,2,* Jianfeng Zeng,1,* Senlin Zhan,1 Tao Chen,1 Yuxiang Wang,1 Guofang Deng1 1Department of Pulmonary Medicine and Tuberculosis, The Third People’s Hospital of Shenzhen, Shenzhen, Guangdong, People’s Republic of China; 2School of Public Health, Health Science Center, Shenzhen University, Shenzhen, Guangdong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Guofang DengDepartment of Pulmonary Medicine and Tuberculosis, The Third People’s Hospital of Shenzhen, No. 29, Bulan Road, Longgang District, Shenzhen, Guangdong 518112, People’s Republic of ChinaTel +86 135 300 27001Fax +86 0755 6123 8928Email jxxk1035@yeah.netObjective: The aim of this study was to assess active tuberculosis-related deaths in Shenzhen city of China to identify major causes of mortality in different age groups.Patients and Methods: Medical records of mortality cases of patients with active TB diagnosed during 2013– 2018 were reviewed. All TB deaths were classified into two broad age groups (the young group: 18– 65 years old and the elderly group: > 65 years old). Causes of death were analyzed based on medical records.Results: A total of 279 mortality cases of active TB were reviewed during the study period. Among them, mean age was 54.0± 20.5 years old; 80.6% (225/279) were male. There were 5.7% and 4.6% MDR/XDRTB patients in the young and elderly group. Newly treated TB accounted for 89.6% in the young group and 85.1% in the elderly group. Pulmonary TB was a major infection type in both groups (65.1% vs 77.0%). Advanced TB (23.4%) and HIV co-infection (20.8%) were the leading causes of deaths in the young group, but deaths in the elderly group were mostly associated with underlying diseases, including cardiovascular disease (52.9%), diabetes (33.3%), COPD (16.1%) and cancer (11.5%). Malnutrition was a significant condition in both groups (43.2