A Nutritional-Inflammatory Composite Score to Support Nursing Risk Stratification in Suspected Multidrug-Resistant Tuberculosis Patients: Implications for Identifying Nontuberculous Mycobacterial Pulmonary Disease.

Authors

Ming Chang, Zhou Wenjuan, Xingzhen Yang, Yuanyuan Zhao

Published in

Journal of global antimicrobial resistance. Sep 04, 2026. Epub Sep 04, 2026.

Abstract

Nontuberculous mycobacterial pulmonary disease (NTM-PD) and multidrug-resistant pulmonary tuberculosis (MDR-PTB) share overlapping clinical and radiological features, leading to frequent misdiagnosis and inappropriate treatment. Simple, low-cost risk stratification tools are needed, particularly for nursing staff in resource-limited settings. This study developed and evaluated a Nutritional-Inflammatory Composite Score (NICS) for differentiating NTM-PD from MDR-PTB.
We retrospectively enrolled 500 patients with suspected MDR-PTB who underwent confirmatory microbiological testing. Final diagnoses were MDR-PTB (n=338, 67.6%) and NTM-PD (n=162, 32.4%). Three logistic regression models were compared: clinical (age, BMI, smoking, diabetes, COPD, bronchiectasis), laboratory (CRP, albumin, ferritin, lymphocytes), and NICS-based (age, BMI, diabetes, COPD, bronchiectasis, and NICS). Model discrimination was assessed by area under the ROC curve (AUC).
NICS was the strongest independent predictor of NTMPD (OR=1.14 per unit increase, 95% CI: 1.08-1.20, p<0.001). The NICS-based model achieved the highest AUC (0.66, 95% CI: 0.61-0.71), compared with the clinical model (AUC=0.57, 95% CI: 0.52-0.62) and the laboratory model (AUC=0.60, 95% CI: 0.54-0.65). Using the Youden derived optimal cutoff, sensitivity was 35.19%, specificity 73.96%, PPV 39.31%, and NPV 70.42% (overall correct classification 61.40%).
NICS improves NTMPD versus MDRPTB discrimination modestly but significantly (ΔAUC = 0.09 vs. clinical model). The nomogram represents a preliminary research instrument for risk estimation; however, the low sensitivity at the optimal threshold precludes its use as a diagnostic tool, limiting its role to hypothesis generation pending prospective validation. Prospective usability testing and external validation remain necessary.

PMID:
42697437
Bibliographic data and abstract were imported from PubMed on 05 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.