• acute exacerbation
• chronic obstructive pulmonary disease
• cytotoxic anti-cancer drug
• immune checkpoint inhibitor
• interstitial pneumonia
• lung cancer
• non-small cell lung carcinoma
• tuberculosis

• Cohort studies
• Endoscopic mucosal resections
• Gastrectomy
• Incidence
• Stomach neoplasms
• Tuberculosis

• Humans
• Cohort Studies
• Stomach Neoplasms/epidemiology
• Stomach Neoplasms/surgery
• Stomach Neoplasms/complications
• Endoscopy/adverse effects
• Gastrectomy/adverse effects
• Tuberculosis/epidemiology
• Tuberculosis/etiology
• Tuberculosis/surgery
• Retrospective Studies
• Treatment Outcome
• Endoscopic Mucosal Resection/adverse effects

• Endoscopic mucosal resection
• Gastrectomy
• Stomach neoplasms
• Tuberculosis

• Humans
• Retrospective Studies
• Incidence
• Endoscopic Mucosal Resection/adverse effects
• Stomach Neoplasms/epidemiology
• Stomach Neoplasms/surgery
• Stomach Neoplasms/diagnosis
• Treatment Outcome
• Cohort Studies
• Risk Factors
• Gastrectomy/adverse effects
• Tuberculosis/epidemiology
• Tuberculosis/etiology
• Gastric Mucosa

• Mycobacterium mageritense
• anti-PD-1 antibody
• breast cancer
• nivolumab
• nontuberculous mycobacteria

• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents, Immunological/adverse effects
• Breast Neoplasms/drug therapy
• Female
• Humans
• Mycobacteriaceae
• Nivolumab/adverse effects
• Programmed Cell Death 1 Receptor

Cancer patients are prone to infections, but the mortality of fatal infections remains unclear. Understanding the patterns of fatal infections in patients with cancer is imperative. In this study, we report the characteristics, incidence, and predictive risk factors of fatal infections among a population-based cancer cohort.

A total of 8,471,051 patients diagnosed with cancer between 1975 and 2016 were retrospectively identified from the Surveillance, Epidemiology, and End Results (SEER) program. The primary outcome was dying from fatal infections. Mortality rates and standardized mortality ratios (SMRs) adjusted for age, sex, race, and calendar year were calculated to characterize the relative risks of dying from fatal infections and to compare with the general population. Furthermore, cumulative mortality rates and the Cox regression models were applied to identify predictive risk factors of fatal infections.

In cancer patients, the mortality rate of fatal infections was 260.1/100,000 person-years, nearly three times that of the general population [SMR, 2.92; 95% (confidence interval) CI 2.91–2.94]. Notably, a decreasing trend in mortality rate of fatal infections was observed in recent decades. SMRs of fatal infections were highest in Kaposi sarcoma (SMR, 162.2; 95% CI 159.4–165.1), liver cancer (SMR, 30.9; 95% CI 30.0–31.8), acute lymphocytic leukemia (SMR, 19.1; 95% CI 17.0–21.4), and acute myeloid leukemia (SMR, 13.3; 95% CI 12.4–14.3). Patients aged between 20 and 39 years old exhibited a higher cumulative mortality rate in the first few years after cancer diagnosis, whereas the cumulative mortality rate of those > 80 years old was rapidly increasing and became the highest approximately 3 years post-cancer diagnosis. Predictive risk factors of dying from fatal infections in cancer patients were the age of 20–39 or > 80 years, male sex, black race, diagnosed with cancer before 2000, unmarried status, advanced cancer stage, and not receiving surgery and radiotherapy, but receiving chemotherapy.

Cancer patients were at high risks of dying from infectious diseases. Certain groups of cancer patients, including those aged between 20 and 39 or > 80 years, as well as those receiving chemotherapy, should be sensitized to the risk of fatal infections.

The online version contains supplementary material available at 10.1007/s40121-021-00433-7.

• Cancer patients
• Cohort studies
• Fatal infections
• SEER
• Survivorship

Cancer is a known risk factor for developing active tuberculosis (TB) disease. The incidence of and risk factors for TB are not known among cancer patients in Thailand. This study aimed to investigate risk factors for TB among cancer patients in an area with endemic TB infections.

We used the Khon Kaen population–based cancer registry and two TB databases to conduct a retrospective cohort study of cancer patients. From 2001 to 2015, we identified 40,948 eligible cancer patients. Following until 2017, we identified cases of TB diagnosed after cancer diagnosis and analyzed primary cancer site, staging, treatment, and demographic factors. Adjusted incidence rate ratios (adj. IRR) were computed to identify risk factors among a sub–set of cancer types (n = 9,733) using Poisson regression.

Among all cancer patients, 472 cases of TB were diagnosed following cancer diagnosis (cumulative incidence = 1.15%, incidence rate = 421.86 cases per 100,000 patients per year). Among the sub–set of cancer types, 206 cases of TB were found (cumulative incidence = 2.11%, incidence rate = 848.26 cases per 100,000 patients per year). Risk factors for TB among cancer patients were sex (p < 0.001) (male adj. IRR = 1.87, 95% CI: 1.36–2.59), age (p < 0.001) (age >70 adj. IRR = 2.36, 95% CI: 1.56-3.55, compared to age ≤50) and cancer site (p < 0.001). Compared to thyroid cancer, TB infection was more associated with lung cancer without histopathological confirmation (adj. IRR = 6.22, 95% CI: 2.57–15.04). Cancer stage and treatment did not show statistically significant trends.

Old age, male sex, and certain cancer types were independent risk factors for TB in cancer patients. Targeted latent TB screening may be appropriate among high risk groups.

• Epidemiology
• Malignancy
• Screening
• Tuberculosis
• latent infection

The aim of the study was to investigate whether use of selective serotonin reuptake inhibitors (SSRIs) was associated with pulmonary tuberculosis.

The case–control study was conducted to analyze the database between 2000 and 2013. Patients aged 20 to 84 years with newly diagnosed pulmonary tuberculosis were selected as the cases (n = 8593). Participants without pulmonary tuberculosis were selected as the controls (n = 43 472). Patients who never had a prescription for SSRIs were defined as never use. Those who ever had a prescription for SSRIs were defined as ever use.

The adjusted odds ratio (OR) of pulmonary tuberculosis was 1.03 for patients with ever use of SSRIs (95% confidence interval [CI]: 0.93-1.14), compared to never use. The adjusted OR of pulmonary tuberculosis was 1.00 for patients with increasing cumulative duration of SSRI use for every 1 month (95% CI: 0.99-1.00), compared to never use. The adjusted OR of pulmonary tuberculosis was 0.99 for patients with increasing cumulative dosage of SSRI use for every 1 mg (95% CI: 0.99-1.00), compared to never use.

No significant association can be detected between SSRI use and pulmonary tuberculosis in Taiwan. No duration-dependent effect or dose-dependent effect of SSRIs use can be detected on the risk of pulmonary tuberculosis.

• Taiwan
• case–control study
• national health insurance program
• pulmonary tuberculosis
• selective serotonin reuptake inhibitors

• Epidemiology
• Oral cancer
• Population-based study
• Tuberculosis

• epidemiology
• gastrectomy
• pulmonary tuberculosis

• Adult
• Aged
• Cohort Studies
• Databases, Factual
• Female
• Gastrectomy/adverse effects
• Humans
• Incidence
• Male
• Middle Aged
• Proportional Hazards Models
• Risk Assessment
• Risk Factors
• Taiwan/epidemiology
• Tuberculosis, Pulmonary/epidemiology
• Tuberculosis, Pulmonary/etiology

• DMARD
• Isoniazid
• Tuberculosis

• Adult
• Aged
• Antitubercular Agents/therapeutic use
• Female
• Humans
• Immunocompromised Host
• Incidence
• Inflammation/immunology
• Inflammation/therapy
• Isoniazid/therapeutic use
• Latent Tuberculosis/drug therapy
• Latent Tuberculosis/epidemiology
• Male
• Middle Aged
• Prevalence
• Retrospective Studies
• Risk Factors
• Salvage Therapy/statistics & numerical data
• Taiwan/epidemiology
• Tertiary Care Centers
• Tuberculosis/drug therapy
• Tuberculosis/epidemiology
• Tuberculosis/prevention & control

Background and Objectives: Although the relationship between the use of proton pump inhibitors (PPIs) and pulmonary tuberculosis (TB) in Taiwan published in 2014. Due to just only one article and not enough comprehensively, we explore this issue.

Methods: We conducted a population-based case-control study to identify 9,422 subjects aged 20 years or older with newly diagnosed pulmonary TB in 2000–2013 as test cases. We then randomly selected 9,422 subjects aged 20 years or older without pulmonary TB as controls. Both cases and controls were matched in terms of sex, age, and comorbidities. Use of PPIs were defined as subjects who had had at least one prescription for these medications before the index date. No use was defined as subjects who had never had a prescription for PPIs before the index date. The odds ratio (OR) and 95% confidence interval (CI) for pulmonary TB associated with PPI use was estimated using the logistic regression model.

Results: The OR of pulmonary TB was 1.31 for subjects who had used PPIs (95% CI 1.22, 1.41) compared with those with no use of the medications. Sub-analysis revealed the OR of pulmonary TB in subjects using PPI per increasing microgram was 1.25 (95% CI 1.19, 1.30).

Conclusions: PPI use is associated with a 1.3-fold increase in odds of developing pulmonary TB in Taiwan. There is a dose-related response between PPI use and pulmonary TB.

• Taiwan National Health Insurance Program
• proton pump inhibitors
• pulmonary tuberculosis

• Lung cancer
• dermatofibrosarcoma
• infection
• tuberculosis (TB)

• cohort study
• comorbidities
• depression
• epidemiology
• pulmonary tuberculosis

Herein, we report a 39-year-old female patient presenting with gastric cancer and tuberculous peritonitis. The differential diagnosis between advanced gastric cancer with peritoneal carcinomatosis and early gastric cancer with peritoneal tuberculosis (TB), and the treatment of these two diseases, were challenging in this case. Physicians should have a high index of suspicion for peritoneal TB if the patient has a history of this disease, especially in areas with a high incidence of TB, such as South Korea. An early diagnosis is critical for patient management and prognosis. A surgical approach including tissue biopsy or laparoscopic exploration is recommended to confirm the diagnosis.

• Peritoneal carcinomatosis
• Stomach neoplasms
• Tuberculous peritonitis

AIM: To examine incidence of tuberculosis (TB) in gastrectomy patients and investigate the risk factors for developing TB after gastrectomy in patients with gastric cancer.

METHODS: A retrospective cohort study of gastrectomy patients with gastric cancer was performed at a university-affiliated hospital in Seoul, South Korea between January 2007 and December 2009. We reviewed patient medical records and collected data associated with the risk of TB, surgery, and gastric cancer. Standardized incidence ratios (SIRs) of TB were calculated to compare the incidence of TB in gastrectomy patients with that in the general Korean population, and risk factors for TB after gastrectomies were analyzed.

RESULTS: Among the 1776 gastrectomy patients, 0.9% (16/1776) developed post-gastrectomy TB, with an incidence of 223.7 cases per 100000 patients per year. The overall incidence of TB in gastrectomy patients, adjusted by sex and age, was significantly higher than that in the general population (SIR = 2.22, 95%CI: 1.27-3.60). Previous TB infection [odds ratio (OR) = 7.1, P < 0.001], lower body mass index (BMI) (kg/m²; OR = 1.21, P = 0.043) and gastrectomy extent (total gastrectomy vs subtotal gastrectomy) (OR = 3.48, P = 0.017) were significant risk factors for TB after gastrectomy in a multivariate analysis.

CONCLUSION: TB incidence after gastrectomy is higher than that in the general population. Previous TB infection, lower BMI, and total gastrectomy are risk factors for TB after gastrectomy in patients with gastric cancer.

• Tuberculosis
• Gastrectomy
• Body mass index
• Risk factor
• Gastric cancer

• Adult
• Aged
• Aged, 80 and over
• Body Mass Index
• Chi-Square Distribution
• Female
• Gastrectomy/adverse effects
• Hospitals, University
• Humans
• Incidence
• Logistic Models
• Longitudinal Studies
• Male
• Medical Records
• Middle Aged
• Multivariate Analysis
• Odds Ratio
• Republic of Korea/epidemiology
• Retrospective Studies
• Risk Factors
• Stomach Neoplasms/surgery
• Treatment Outcome
• Tuberculosis/diagnosis
• Tuberculosis/epidemiology
• Young Adult

• Age Factors
• Aged
• Cohort Studies
• Comorbidity
• Diabetes Mellitus/epidemiology
• Dyslipidemias/epidemiology
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Proportional Hazards Models
• Retrospective Studies
• Risk Factors
• Sex Factors
• Stomach Neoplasms/epidemiology
• Stomach Neoplasms/mortality
• Taiwan/epidemiology
• Tuberculosis/epidemiology

• HIR 10-001 HSRD VA

The acid-suppressive agents have been linked with an increased risk of infectious disease. The relationship between these drugs and Mycobacterium Tuberculosis (TB) was not been reported.

We conducted a case–control study using data from National Health Insurance research database of Taiwan. From 1996 till 2008, and 6541 cases were defined as TB infection/activation (ICD-9 coding plus prescription two of four first-line anti-TB regimen for at least one month). Control subjects who were matched to the TB cases by age and sex were selected with 10:1 ratio. Medical records including acid-suppressive agent prescription and comorbidity, and socioeconomic status were analyzed.

TB infection/activation was more frequent to comorbidity with chronic diseases, alcohol abuse, malignancy, immune deficient/suppression status and acid-related disease (peptic ulcer, reflux esophagitis). Among the TB cases, there was higher exposure record to acid-suppressive agents within 3 months before TB index date (OR 2.43(2.06-2.88) and 1.90 (1.68-2.14) for proton pump inhibitor (PPI) and histamine 2 receptor antagonist (H₂RA) respectively). After adjusting confounding factors, PPIs prescription 3 months before TB index date had an association of TB infection/activation (adjusted OR 1.63(1.61-1.63)). Similar result was found in H₂RA user (adjusted OR 1.51(1.50-1.52)). The association of acid-suppressive agents in TB infection/activation was fade gradually when the drug prescription period extended.

Recent prescription of acid-suppressive agent seems to associate the TB infection/activation. In the society where TB was prevalent, evaluation of pulmonary TB before prescription of PPI or H₂RA is warranted.

• Adult
• Aged
• Female
• Gastrectomy/adverse effects
• Humans
• Incidence
• Male
• Middle Aged
• Mycobacterium Infections, Nontuberculous/epidemiology
• Republic of Korea/epidemiology
• Stomach Neoplasms/surgery
• Tertiary Care Centers
• Tuberculosis, Pulmonary/epidemiology

Mycobacterium tuberculosis is a necessary, but not sufficient, cause of tuberculosis. A number of studies have addressed the issue of risk factors for tuberculosis development. Croatia is a European country with an incidence rate of 14/100 000 which is slowly decreasing. The aim of this study is to evaluate the potential demographic, socioeconomic, behavioural and biological risk factors for tuberculosis in Croatia in comparison to other high-income, low-incidence European countries.

A total of 300 tuberculosis patients were matched for age, sex and county of residence to 300 controls randomly selected from general practitioners’ registers. They were interviewed and their medical records were evaluated for variables broadly described as potential risk factors.

In multiple logistic regression, the following factors were significant: parents born in a particular neighbouring county (Bosnia and Herzegovina) (OR = 3.90, 95% CI 2.01-7.58), the lowest level of education (OR = 3.44, 95% CI 1.39-8.50), poor household equipment (OR = 4.72, 95% CI 1.51-14.76), unemployment (OR = 2.69, 95% CI 1.18-6.16), contact with tuberculosis (OR = 2.19, 95% CI 1.27-3.77), former (OR = 2.27, 95% CI 1.19-4.33) and current smoking habits (OR = 2.35, 95% CI 1.27-4.36), diabetes (OR = 2.38, 95% CI 1.05-5.38), a malignant disease (OR = 5.79, 95% CI 1.49-22.42), being underweight in the previous year (OR = 13.57, 95% CI 1.21-152.38).

In our study, the identified risk groups for tuberculosis reflect a complex interaction between socioeconomic conditions, lifestyle and non-communicable diseases. Interventions focused on poverty will undoubtedly be useful, but not sufficient. Tuberculosis control would benefit from a combination of broad public health activities aimed at the prevention and control of risky lifestyles and non-communicable diseases, interventions outside the health sector, and efforts to constantly improve the Croatian national tuberculosis programme.

• Aged
• Axilla
• Carcinoma, Ductal, Breast/complications
• Carcinoma, Ductal, Breast/pathology
• Female
• Granuloma/pathology
• Humans
• Lymph Nodes/pathology
• Tuberculosis, Lymph Node/complications
• Tuberculosis, Lymph Node/pathology