Tuberculosis is a global public health problem. Extra-pulmonary tuberculosis accounts for an increasing proportion of cases worldwide, although information about epidemiological, clinical, or microbiological factors is lacking. We conducted a retrospective observational study of tuberculosis cases diagnosed between 2016 and 2021, classified into Pulmonary and Extra-pulmonary tuberculosis. Univariable and multivariable logistic regression models were used to investigate risk factors of Extra-pulmonary tuberculosis. 20.9% of overall cases were classified as Extra-pulmonary tuberculosis, with a rising trend from 22.6% in 2016 to 27.9% in 2021. Lymphatic tuberculosis accounted for 50.6% of cases, followed by pleural tuberculosis (24.1%). 55.4% of cases belonged to foreign-born patients. Microbiological culture tested positive in 92.8% of Extra-pulmonary cases. Logistic regression analysis showed that women were more predisposed to develop Extra-pulmonary tuberculosis (aOR 2.46, 95% CI 1.45–4.20) as well as elderly patients (aged ≥ 65 years) (aOR 2.47, 95% CI 1.19–5.13) and persons with previous history of tuberculosis (4.99, 95% CI 1.40–17.82). Extra-pulmonary Tuberculosis have increased within our study period. A profound decline occurred in 2021 tuberculosis cases, probably due to COVID-19. Women, elderly population, and persons with previous history of tuberculosis are at higher risk of developing Extra-pulmonary tuberculosis in our setting.

Influenza is a well-known cause of acute respiratory disease. It is generally a self-limiting infection with systemic and respiratory symptoms, and usually resolves after 3–6 days in most patients. Viral clearance in the respiratory tract occurs after 3–5 days [ 1 x 1 Hayden, FG. Prevention and treatment of influenza in immunocompromised patients. Am J Med. 1997; 102: 55–60 Abstract | Full Text | Full Text PDF | PubMed | Google Scholar See all References 1 ]. However, a complicated course consisting of severe respiratory illness, exacerbation of underlying diseases and the need for intensive care has been reported for some patients [ 2 x 2 Thompson, WW, Shay, DK, Weintraub, E et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA. 2003; 289: 179–186 Crossref | PubMed | Scopus (2490) | Google Scholar See all References , 3 x 3 Thompson, WW, Shay, DK, Weintraub, E et al. Influenza‐associated hospitalizations in the United States. JAMA. 2004; 292: 1333–1340 Crossref | PubMed | Scopus (1486) | Google Scholar See all References ]. The recently described pandemic influenza A(H1N1) virus had a more aggressive course in specific populations, such as young patients and pregnant women [ 4 x 4 Chowell, G, Bertozzi, SM, Colchero, MA et al. Severe respiratory disease concurrent with the circulation of H1N1 influenza. N Engl J Med. 2009; 361: 674–679 Crossref | PubMed | Scopus (526) | Google Scholar See all References , 5 x 5 Jamieson, DJ, Honein, MA, Rasmussen, SA et al. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet. 2009; 374: 451–458 Abstract | Full Text | Full Text PDF | PubMed | Scopus (899) | Google Scholar See all References ].

Objectives: Human herpesvirus 6 is associated with a variety of complications in immunocompromised patients, but no studies have systematically and comprehensively assessed the impact of human herpesvirus 6 reactivation, and its interaction with cytomegalovirus, in ICU patients. Design: We prospectively assessed human herpesvirus 6 and cytomegalovirus viremia by twice-weekly plasma polymerase chain reaction in a longitudinal cohort study of 115 adult, immunocompetent ICU patients. The association of human herpesvirus 6 and cytomegalovirus reactivation with death or continued hospitalization by day 30 (primary endpoint) was assessed by multivariable logistic regression analyses. Setting: This study was performed in trauma, medical, surgical, and cardiac ICUs at two separate hospitals of a large tertiary care academic medical center. Patients: A total of 115 cytomegalovirus seropositive, immunocompetent adults with critical illness were enrolled in this study. Interventions: None. Measurements and Main Results: Human herpesvirus 6 viremia occurred in 23% of patients at a median of 10 days. Human herpesvirus 6B was the species detected in eight samples available for testing. Most patients with human herpesvirus 6 reactivation also reactivated cytomegalovirus (70%). Severity of illness was not associated with viral reactivation. Mechanical ventilation, burn ICU, major infection, human herpesvirus 6 reactivation, and cytomegalovirus reactivation were associated with the primary endpoint in unadjusted analyses. In a multivariable model adjusting for mechanical ventilation and ICU type, only coreactivation of human herpesvirus 6 and cytomegalovirus was significantly associated with the primary endpoint (adjusted odds ratio, 7.5; 95% CI, 1.9–29.9; p = 0.005) compared to patients with only human herpesvirus 6, only cytomegalovirus, or no viral reactivation. Conclusions: Coreactivation of both human herpesvirus 6 and cytomegalovirus in ICU patients is associated with worse outcome than reactivation of either virus alone. Future studies should define the underlying mechanism(s) and determine whether prevention or treatment of viral reactivation improves clinical outcome.

Matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) for the identification of nontuberculous mycobacterial (NTM) isolates was evaluated in this study. Overall, 125 NTM isolates were analyzed by MALDI-TOF and GenoType CM/AS. Identification by 16S rRNA/ hsp65 sequencing was considered the gold standard. Agreements between MALDI-TOF and GenoType CM/AS with the reference method were, respectively, 94.4% and 84.0%. In 17 cases (13.6%), results provided by GenoType and MALDI-TOF were discordant; however, the reference method agreed with MALDI-TOF in 16/17 cases (94.1%; P = 0.002).