Retrospective study of clinical and lesion characteristics of patients undergoing surgical treatment for Pulmonary Tuberculosis in Georgia

Sergo Vashakidze, Albert Despuig, Shota Gogishvili, Keti Nikolaishvili, Natalia Shubladze, Zaza Avaliani, Nestan Tukvadze, Martí Casals, Joan A. Caylà, Pere Joan Cardona, Cristina Vilaplana

Research output: Contribution to journalArticle

Abstract

Objectives: Our aim was to retrospectively compare clinical data and characteristics of removed lesions of the cohort of patients undergoing therapeutical surgery for their tuberculosis. Design and methods: Demographic and epidemiological details, clinical data, data on the surgery performed, macroscopic characteristics of the TB lesions removed, and outcome were recorded retrospectively from the 137 patients who underwent therapeutical surgery for their TB in Tbilisi, Georgia during 2014 and 2015. Results: Men represented 70% of the included patients, presented more comorbidities and underwent operation earlier in terms of days between diagnostic and surgery. Women underwent operation at younger ages, and in MDR/XDR-TB cases, showed higher percentages of sputum conversion at >2 months and of fresh necrosis in the surgical specimens, suggesting a worse evolution. Half of cases were MDR/XDR-TB cases. In spite of being considered microbiologically cured according to WHO, a non despricable percentage of cases showed viable bacilli in the surgical specimen. Even if no causality could be statistically demonstrated, differences could be encountered according to gender and drug susceptibility of the responsible strains. Conclusions: According to our results, host factors such as gender, type of necrosis found in the lesions, size of lesions and presence of viable bacilli in the surgical specimen, should be included in future studies on therapeutical surgery of TB. As most of studies are done in MDR/XDR-TB, more data on DS-TB operated cases are needed. Our results also highlight that, in spite of achieving the microbiologically cured status, sterilization might not occur, and thus new biomarkers and new methods to evaluate the healing process of TB patients are urgently needed and radiological assays should be taken into account.

Original languageEnglish (US)
JournalInternational Journal of Infectious Diseases
DOIs
StateAccepted/In press - Oct 7 2016
Externally publishedYes

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Pulmonary Tuberculosis
Extensively Drug-Resistant Tuberculosis
Retrospective Studies
Bacillus
Necrosis
Epidemiologic Methods
Therapeutics
Sputum
Causality
Comorbidity
Tuberculosis
Biomarkers
Demography
Pharmaceutical Preparations

Keywords

  • DS-TB
  • Gender
  • MDR/XDR-TB
  • Necrosis
  • Surgery
  • Tuberculosis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Retrospective study of clinical and lesion characteristics of patients undergoing surgical treatment for Pulmonary Tuberculosis in Georgia. / Vashakidze, Sergo; Despuig, Albert; Gogishvili, Shota; Nikolaishvili, Keti; Shubladze, Natalia; Avaliani, Zaza; Tukvadze, Nestan; Casals, Martí; Caylà, Joan A.; Cardona, Pere Joan; Vilaplana, Cristina.

In: International Journal of Infectious Diseases, 07.10.2016.

Research output: Contribution to journalArticle

Vashakidze, S, Despuig, A, Gogishvili, S, Nikolaishvili, K, Shubladze, N, Avaliani, Z, Tukvadze, N, Casals, M, Caylà, JA, Cardona, PJ & Vilaplana, C 2016, 'Retrospective study of clinical and lesion characteristics of patients undergoing surgical treatment for Pulmonary Tuberculosis in Georgia', International Journal of Infectious Diseases. https://doi.org/10.1016/j.ijid.2016.12.009
Vashakidze, Sergo ; Despuig, Albert ; Gogishvili, Shota ; Nikolaishvili, Keti ; Shubladze, Natalia ; Avaliani, Zaza ; Tukvadze, Nestan ; Casals, Martí ; Caylà, Joan A. ; Cardona, Pere Joan ; Vilaplana, Cristina. / Retrospective study of clinical and lesion characteristics of patients undergoing surgical treatment for Pulmonary Tuberculosis in Georgia. In: International Journal of Infectious Diseases. 2016.
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abstract = "Objectives: Our aim was to retrospectively compare clinical data and characteristics of removed lesions of the cohort of patients undergoing therapeutical surgery for their tuberculosis. Design and methods: Demographic and epidemiological details, clinical data, data on the surgery performed, macroscopic characteristics of the TB lesions removed, and outcome were recorded retrospectively from the 137 patients who underwent therapeutical surgery for their TB in Tbilisi, Georgia during 2014 and 2015. Results: Men represented 70{\%} of the included patients, presented more comorbidities and underwent operation earlier in terms of days between diagnostic and surgery. Women underwent operation at younger ages, and in MDR/XDR-TB cases, showed higher percentages of sputum conversion at >2 months and of fresh necrosis in the surgical specimens, suggesting a worse evolution. Half of cases were MDR/XDR-TB cases. In spite of being considered microbiologically cured according to WHO, a non despricable percentage of cases showed viable bacilli in the surgical specimen. Even if no causality could be statistically demonstrated, differences could be encountered according to gender and drug susceptibility of the responsible strains. Conclusions: According to our results, host factors such as gender, type of necrosis found in the lesions, size of lesions and presence of viable bacilli in the surgical specimen, should be included in future studies on therapeutical surgery of TB. As most of studies are done in MDR/XDR-TB, more data on DS-TB operated cases are needed. Our results also highlight that, in spite of achieving the microbiologically cured status, sterilization might not occur, and thus new biomarkers and new methods to evaluate the healing process of TB patients are urgently needed and radiological assays should be taken into account.",
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AU - Nikolaishvili, Keti

AU - Shubladze, Natalia

AU - Avaliani, Zaza

AU - Tukvadze, Nestan

AU - Casals, Martí

AU - Caylà, Joan A.

AU - Cardona, Pere Joan

AU - Vilaplana, Cristina

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AB - Objectives: Our aim was to retrospectively compare clinical data and characteristics of removed lesions of the cohort of patients undergoing therapeutical surgery for their tuberculosis. Design and methods: Demographic and epidemiological details, clinical data, data on the surgery performed, macroscopic characteristics of the TB lesions removed, and outcome were recorded retrospectively from the 137 patients who underwent therapeutical surgery for their TB in Tbilisi, Georgia during 2014 and 2015. Results: Men represented 70% of the included patients, presented more comorbidities and underwent operation earlier in terms of days between diagnostic and surgery. Women underwent operation at younger ages, and in MDR/XDR-TB cases, showed higher percentages of sputum conversion at >2 months and of fresh necrosis in the surgical specimens, suggesting a worse evolution. Half of cases were MDR/XDR-TB cases. In spite of being considered microbiologically cured according to WHO, a non despricable percentage of cases showed viable bacilli in the surgical specimen. Even if no causality could be statistically demonstrated, differences could be encountered according to gender and drug susceptibility of the responsible strains. Conclusions: According to our results, host factors such as gender, type of necrosis found in the lesions, size of lesions and presence of viable bacilli in the surgical specimen, should be included in future studies on therapeutical surgery of TB. As most of studies are done in MDR/XDR-TB, more data on DS-TB operated cases are needed. Our results also highlight that, in spite of achieving the microbiologically cured status, sterilization might not occur, and thus new biomarkers and new methods to evaluate the healing process of TB patients are urgently needed and radiological assays should be taken into account.

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