Mycobacterium tuberculosis bacteremia in adults and children: A systematic review and meta-Analysis

SETTING: 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. RESULT S : 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. CONCLUS ION: While M.Tuberculosis bacteremia appears relatively common in adults, particularly those with HIV infection, bloodstream M.Tuberculosis appears to be rare in children. © 2016 The Union.