Mycobacterium tuberculosis bacteremia in adults and children: a systematic review and meta-analysis

SETTINGp: Among human immunodeficiency virus (HIV) infected adults living in tuberculosis (TB) endemic settings, Mycobacterium tuberculosis is a common cause of bloodstream infections. Although young children have an increased propensity for M. tuberculosis dissemination, M. tuberculosis bacteremia...

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Bibliographic Details
Published in:The international journal of tuberculosis and lung disease 2016-07, Vol.20 (7), p.895-902
Main Authors: Pavlinac, P. B., Lokken, E. M., Walson, J. L., Richardson, B. A., Crump, J. A., John-Stewart, G. C.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Adults And Children
Age Distribution
Aged
Aged, 80 and over
Bacteremia - diagnosis
Bacteremia - epidemiology
Bacteremia - microbiology
Child
Child, Preschool
Coinfection
HIV Infections - epidemiology
Human immunodeficiency virus
Humans
Infant
Lentivirus
M. Tuberculosis Bacteremia
Middle Aged
Mycobacterial Sepsis
Mycobacterium tuberculosis
Mycobacterium tuberculosis - isolation & purification
Prevalence
Systematic Review
Tuberculosis - diagnosis
Tuberculosis - epidemiology
Tuberculosis - microbiology
Young Adult
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Summary:SETTINGp: Among human immunodeficiency virus (HIV) infected adults living in tuberculosis (TB) endemic settings, Mycobacterium tuberculosis is a common cause of bloodstream infections. Although young children have an increased propensity for M. tuberculosis dissemination, M. tuberculosis bacteremia is infrequently described in children.OBJECTIVE: To determine the prevalence of M. tuberculosis bacteremia in adult and pediatric patients and to examine sources of heterogeneity between estimates.DESIGN: Systematic review and meta-analysis.RESULTS: Of 1077 reviewed abstracts, 27 publications met the inclusion criteria, yielding 29 independent M. tuberculosis bacteremia prevalence estimates: 22 in adults, 6 in children, and 1 not stratified by age group. The random effects pooled M. tuberculosis bacteremia prevalence in adults was 13.5% (95%CI 10.8-16.2) and 0.4% (95%CI 0-0.9) in children (P for difference = 0.004). Restricting analyses to HIV-infected participants, pooled M. tuberculosis bacteremia prevalence from 21 adult studies was 15.5% (95%CI 12.5-18.5) and 0.8% (95%CI 0-1.8) in three pediatric studies (P = 0.001). Inclusion of pre-determined study-level confounders did not account for observed differences in M. tuberculosis bacteremia prevalence between age groups.CONCLUSION: While M. tuberculosis bacteremia appears relatively common in adults, particularly those with HIV infection, bloodstream M. tuberculosis appears to be rare in children.
ISSN:1027-3719
1815-7920
DOI:10.5588/ijtld.15.0773