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Background: Diabetes mellitus (DM) triples a person's risk of active tuberculosis (TB) and is associated with increased mortality. It is unclear whether diabetes status and/or the associated renal dysfunction is associated with poor TB outcomes in New Zealand, which has high diabetes screening. Aim: To characterise the population of TB‐DM and TB‐alone to assess the effect of diabetes status and renal function on hospitalisation and mortality. Methods: Clinical records from all adult patients diagnosed with TB in Auckland over a 6‐year period (2010–2015) were reviewed. Baseline demographics, clinical presentation and microbiological data were assessed to compare the rates of hospitalisation and mortality between those with TB‐DM and TB‐alone. Statistical significance was defined as P < 0.05. Results: A total of 701 patients was identified with TB; 120 (17%) had an unknown diabetes status and were excluded, and 135 had co‐existing diabetes. The TB‐DM and TB‐alone groups had similar distribution of TB site and proportions of Mycobacterium tuberculosis culture positivity. Univariate analysis showed TB‐DM patients had statistically significantly higher proportions of acute hospitalisation and mortality. Multivariate logistic regression showed only a reduced estimated glomerular filtration rate (eGFR) accounted for the higher rates of hospitalisation, with the odds of hospitalisation increasing by 2% for every unit decrease in eGFR. The odds of mortality increased by 6% for every year increase in age, and the odds of mortality increased by 3% for every unit reduction in eGFR. Conclusions: Diabetes is associated with higher TB hospitalisation and mortality; however, this is likely mediated by increased age and chronic kidney disease. [ABSTRACT FROM AUTHOR]

Competing Interests: Dr Murdoch reports he is a member of the panel for the Office of the Prime Minister’s Chief Science Advisor’s project on Antimicrobial Resistance and Infectious Diseases. Mr McRae reports he is a member of the New Zealand Antimicrobial Stewardship/Infection Pharmacist Expert Group, and a member of the Infection Prevention Advisory Group for ACC. Ms Mccall reports she is a member of the Canterbury District Health Board Hospital Antimicrobial Stewardship Committee. Dr Maze reports he is a member of the Canterbury District Health Board Hospital Antimicrobial Stewardship Committee. Ms Lim reports that she is a member of the New Zealand Antimicrobial Stewardship/Infection Pharmacist Expert Group and Southern District Health Board Antimicrobial Stewardship Committee. Miss Li reports that she is a member of the New Zealand Antimicrobial Stewardship/Infection Pharmacist Expert Group and a member of the Capital and Coast District Health Board Antimicrobial Stewardship Committee. Dr Kelly reports he is Chair of the National Infection Prevention and Control Expert Group, Ministry of Health. Mr Issa reports he is a member of the New Zealand Antimicrobial Stewardship/Infection Pharmacist Expert Group; a member of the Waikato District Health Board, Antimicrobial Steering Group; coordinator on the New Zealand Hospital Pharmacists’ Association – Infectious Disease/Antimicrobial Stewardship Special Interest Network; a member of the New Zealand Hospital Pharmacists’ Association; and a member of Pharmaceutical Society of New Zealand. Dr Howard reports involvement in writing antimicrobial guidelines at Waikato District Health Board. Mrs Hardie reports she is a member of the New Zealand Antimicrobial Stewardship/Infection Pharmacist Expert Group and member of the Waitematā District Health Board Antimicrobial Stewardship Committee. Dr Gardiner reports that she is co-lead for the New Zealand Antimicrobial Stewardship/Infection Pharmacist Expert Group; a member of the panel for the Office of the Prime Minister’s Chief Science Advisor’s project on Antimicrobial Resistance and Infectious Diseases; a member of the Steering Group for the ACC scoping report on developing national antimicrobial guidance for NZ; and Secretary of the Canterbury Antimicrobial Stewardship Strategic Group and Secretary of the CDHB Hospital Antimicrobial Stewardship Committee. Mr Duffy reports that he is co-lead for the New Zealand Antimicrobial Stewardship/Infection Pharmacist Expert Group; a member of the Ministry of Health AMR Co-ordination (HARC) Group; a member of the Steering Group for the ACC scoping report on developing national antimicrobial guidance for NZ; a member of the PTAC Anti-infective sub-committee (PHARMAC); and a member of Auckland DHB Antimicrobial Stewardship Committee. Ms du Plessis reports that she is Lead for the Counties-Manukau Hospital Antimicrobial Stewardship Program and Chair for the Counties-Manukau Hospital Antimicrobial Stewardship Committee. Dr Chambers reports being Deputy Chair of Canterbury District Health Board Hospital Antimicrobial Stewardship Committee; a member of the reference group for the Prime Minister’s Chief Science Advisor’s project on Antimicrobial Resistance and Infectious Diseases; and a member of PTAC Anti-infective sub-committee (PHARMAC). Dr Campbell reports that she is the Pharmaceutical Society of NZ representative on the NZ Antimicrobial Stewardship/Infection Pharmacist Expert Group; a member of the Ministry of Health Antimicrobial Resistance Coordination Group representing the Pharmaceutical Society of New Zealand; and a member of the Reference Group for the Office of the Prime Minister’s Chief Science Advisor’s project on Antimicrobial Resistance and Infectious Diseases. Dr Bupha-Intr reports that she is a member of the Capital and Coast DHB Antimicrobial Stewardship Committee. Dr Briggs reports that he is a member of the PTAC Anti-Infective Subcommittee (PHARMAC). Dr Birch reports being on the Canterbury District Health Board Hospital Antimicrobial Stewardship Committee. Dr Betty reports having provided advice to the panel for the Office of the Prime Minister’s Chief Science Advisor’s project on Antimicrobial Resistance and Infectious Diseases, and being Medical Director of the Royal NZ College of General Practice. Dr Batlle-Perales reports being a member of the Antimicrobial Steering Group at Waikato Hospital. Brendan Arnold is the clinical lead for Antimicrobial Stewardship at Southern District Health Board.