@article{0d699ebee4444b86acaf703012e37a35,
title = "Predictors and outcomes of mycobacteremia among HIV-infected smear- negative presumptive tuberculosis patients in Uganda",
abstract = "Background: Sputum smear microscopy for tuberculosis (TB) diagnosis lacks sensitivity in HIV-infected symptomatic patients and increases the likelihood that mycobacterial infections particularly disseminated TB will be missed; delays in diagnosis can be fatal. Given the duration for MTB growth in blood culture, clinical predictors of MTB bacteremia may improve early diagnosis of mycobacteremia. We describe the predictors and mortality outcome of mycobacteremia among HIV-infected sputum smear-negative presumptive TB patients in a high prevalence HIV/TB setting. Methods: Between January and November 2011, all consenting HIV-infected adults suspected to have TB (presumptive TB) were consecutively enrolled. Diagnostic assessment included sputum smear microscopy, urine Determine TB lipoarabinomannan (LAM) antigen test, mycobacterial sputum and blood cultures, chest X-ray, and CD4 cell counts in addition to clinical and socio-demographic data. Patients were followed for 12 months post-enrolment. Results: Of 394 sputum smear-negative participants [female, 63.7{\%}; median age (IQR) 32 (28-39) years], 41/394 (10.4{\%}) had positive mycobacterial blood cultures (mycobacteremia); all isolates were (MTB). The median CD4 cell count was significantly lower among patients with mycobacteremia when compared with those without (CD4 31 versus 122 cells/μL, p3), male gender and positive lateral flow urine TB LAM test predicted mycobacteremia in HIV-infected smear-negative presumptive TB patients in this high prevalence TB/HIV setting.",
keywords = "Bacteremia, HIV, LAM, Mortality, Mycobacterial infections, Predictors, Smear- negative, Sub-Saharan Africa",
author = "Lydia Nakiyingi and Willy Ssengooba and Damalie Nakanjako and Derek Armstrong and Molly Holshouser and Kirenga, {Bruce J.} and Maunank Shah and Harriet Mayanja-Kizza and Joloba, {Moses L.} and Ellner, {Jerrold J.} and Dorman, {Susan E.} and Manabe, {Yukari C}",
year = "2015",
month = "2",
day = "15",
doi = "10.1186/s12879-015-0812-4",
language = "English (US)",
volume = "15",
journal = "BMC Infectious Diseases",
issn = "1471-2334",
publisher = "BioMed Central",
number = "1",
}