Factors influencing sputum smear and culture conversion time among patients with new case pulmonary tuberculosis

2006 ◽  
Vol 61 (2) ◽  
pp. 231-235 ◽  
Author(s):  
M. Güler ◽  
E. Ünsal ◽  
B. Dursun ◽  
Ö. AydIn ◽  
N. Capan
Keyword(s):  
Pulmonary Tuberculosis ◽  
Sputum Smear ◽  
Factors Influencing ◽  
Conversion Time ◽  
Culture Conversion

scholarly journals Factors Influencing Sputum Smear and Culture Conversion Time among Patients with Pulmonary Tuberculosis

2018 ◽  
Vol 1 (01) ◽  
pp. 41-46
Author(s):  
Pushpa Man Shrestha ◽  
Minani Gurung ◽  
Nabin Kumar Chaudhary
Keyword(s):  
Pulmonary Tuberculosis ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Smoking Habit ◽  
Sputum Smear ◽  
Erythrocyte Sedimentation ◽  
Sputum Conversion ◽  
Conversion Time ◽  
Index Value ◽  
Culture Conversion

Introduction: Pulmonary tuberculosis is a contagious bacterial infection that involves the lungs and it may spread to other organs. Sputum smear and culture conversion are important indicators for the effectiveness of treatment and the infectivity of the patient. The present study aims to find sputum smear and culture conversion time and the factors that influence the conversion time among tuberculosis patients at National Tuberculosis Centre in Nepal. Methods: A total of 54 patients, who were diagnosed with laboratory confirmed pulmonary tuberculosis and under antitubercular therapy were monitored for sputum smear and culture conversion time. The blood specimens from each patient were processed for hemoglobin, platelets, erythrocyte sedimentation rate and blood glucose levels. Patient’s clinical history, risk factors that prolong conversion time and sociodemographic information were also collected by direct interview. Results: The mean sputum smear and culture conversion were found to be 54.4 days and 45.5 days respectively. Old age, smoking habit, low body mass index value, Treatment category II, initial bacillary load and abnormal erythrocyte sedimentation rate values were found to be associated with long sputum conversion time. Radiographic involvement of only left lungs, presence of fewer symptoms, aged between 15-45 years, having normal weight, without smoking habit and being married, were found to be associated with short sputum conversion time. Conclusions: The sputum microscopy, old age, smoking habit, low body mass index value, treatment category II, initial bacillary load and abnormal erythrocyte sedimentation rate value had been found to be significantly associated with long sputum conversion time.

scholarly journals Factors Influencing Sputum Conversion among Smear-Positive Pulmonary Tuberculosis Patients in Morocco

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Khalid Bouti ◽  
Mohammed Aharmim ◽  
Karima Marc ◽  
Mouna Soualhi ◽  
Rachida Zahraoui ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Stepwise Regression ◽  
Control Measures ◽  
Sputum Smear ◽  
Tuberculosis Patients ◽  
Infection Control Measures ◽  
Factors Influencing ◽  
Smear Positive Pulmonary Tuberculosis ◽  
Sputum Conversion ◽  
A Prospective Study

Background. Sputum smear-positive pulmonary tuberculosis patients expel infectious viable bacilli for a period following the commencement of treatment. Objective. To determine the time to sputum smear conversion and study the factors influencing it. Design. A prospective study was undertaken at our hospital in Rabat over a six-month period on a cohort of 119 sputum smear positive patients. Patients were followed up fortnightly. At each followup, specimens were collected and processed for microscopy using standard protocol. Results. 96.6% of our patients completed the study (4 deaths). Sputum conversion rate was 42% after two weeks, 73% after one month, and 95% after two months. Univariate and stepwise regression analysis showed that patients who had high smear grading, miliary, and bilateral radiologic lesions were more likely to undergo delayed sputum conversion (P<0.05). Other factors were thought to influence sputum conversion but were not statistically proven in our study. Conclusion. Since viable bacilli continue to be expelled for up to two months, infection control measures should be maintained for such a time. Patients with high smear grading, miliary, and bilateral radiologic lesions need to be monitored more closely.

scholarly journals 792. Number and Volume of Cavitary Lesions on Chest Computed Tomography Associated With Prolonged Time to Culture Conversion in Drug-Susceptible Pulmonary Tuberculosis

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S284-S284
Author(s):  
Alfonso Hernandez
Keyword(s):  
Computed Tomography ◽  
Pulmonary Tuberculosis ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Chest Roentgenogram ◽  
Sputum Smear ◽  
Chest Computed Tomography ◽  
Median Difference ◽  
Cox Proportional Hazards Models ◽  
Culture Conversion

Abstract Background Cavitary lesions (CLs) may be a marker of poor treatment response in pulmonary tuberculosis (PTB). Identification of CLs by chest roentgenogram (CXR) has important limitations. Chest computed tomography (CT) is more sensitive than CXR to detect CLs but the clinical relevance of CLs identified by CT remains understudied. We compared detection of CLs between CT and CXR and assessed their association with time to sputum culture conversion (tSCC). We hypothesized that increasing number and volume of CLs on CT would be associated with prolonged tSCC. Methods Retrospective cohort study of 141 culture confirmed PTB patients who underwent chest CT. We used multivariate Cox proportional hazards models to evaluate the association between chest radiological features and tSCC. Results Seventy-five (53%) patients had one or more CLs on CT. CT identified cavities in 31% of patients without a CL on CXR. Detection of cavity on CT was associated with an increased median [IQR] time to culture conversion (15 [7–35] days among noncavitary CT vs. 39 [25–55] days among cavitary CT; P &lt; 0.0001). Among patients without CL on CXR, detection of CL on CT was associated with prolonged tSCC (median difference (CI): 16 (7–25) days, P = 0.0008). Similar results were observed among patients with 3–4+ sputum smear (median difference: 19.5 (8–31) days, P = 0.001). Adjusted Kaplan–Meier curves of number and volume of CLs and tSCC are shown in Figure 1. After confounder adjustment patients with single and multiple CL had a prolonged tSCC relative to patients without CLs on CT (adjusted Hazard Ratio [aHR] 0.56 (0.32–0.97) and 0.31 (0.16–0.60), respectively). Similarly, patients with CL volume 25 mL or more had a prolonged tSCC (aHR 0.39 (0.21–0.72)). CXR CL was not associated with prolonged tSCC. Conclusion We observed a dose–response relationship between increasing number and volume of CLs on CT and delayed tSCC independent of sputum bacillary load. Our findings highlight a role for CT in a clinical research setting to predict shorter time to culture conversion. Disclosures All authors: No reported disclosures.

scholarly journals How Soon Should Patients with Smear-Positive Tuberculosis Be Released from Inpatient Isolation?

2010 ◽  
Vol 31 (1) ◽  
pp. 78-84 ◽  
Author(s):  
David J. Horne ◽  
Catherine O. Johnson ◽  
Eyal Oren ◽  
Christopher Spitters ◽  
Masahiro Narita
Keyword(s):  
Survival Analysis ◽  
Confidence Interval ◽  
Pulmonary Tuberculosis ◽  
Patient Characteristics ◽  
Hazard Ratio ◽  
Bivariate Analysis ◽  
Sputum Smear ◽  
Patient Counseling ◽  
Factors Associated ◽  
Culture Conversion

Objective.In patients with smear-positive pulmonary tuberculosis who are hospitalized or reside in congregate settings, guidelines recommend airborne infection isolation until sputum smear results are negative. Studies have identified factors associated with delayed sputum smear and culture conversion in patients with tuberculosis. Because these studies did not use methods of survival analysis, estimates of time to sputum smear conversion that are based on initial patient characteristics are not available. The ability to predict time to sputum smear conversion could be useful for programmatic planning and patient counseling.Methods.We performed a cohort study using survival analysis to identify factors associated with time to sputum smear and culture conversion. We defined the time to sputum smear conversion as the time elapsed from the start of treatment to the first date of sustained conversion.Results.Ninety-eight patients had sputum smear samples positive for acid-fast bacilli. Lower initial smear grade (on 1+ to 4+ scale) and absence of cavitation on chest radiograph were associated with earlier sputum smear conversion in bivariate analysis. In multiple regression analysis, initial smear grade (hazard ratio, 0.45; 95% confidence interval, 0.35-0.57) and drug resistance (hazard ratio, 2.30; 95% confidence interval, 1.08-4.89) remained statistically significant; a model comprising only initial smear grade performed almost as well. Predictors of sputum culture conversion were similar.Conclusions.Initial smear grade was the strongest predictor of time to sputum smear and culture conversion in patients with pulmonary tuberculosis and may be a useful predictor for programmatic planning and patient counseling.

scholarly journals Plasma chemokines are baseline predictors of unfavorable treatment outcomes in pulmonary tuberculosis

2020 ◽  
Author(s):  
Nathella P Kumar ◽  
Kadar Moideen ◽  
Arul Nancy ◽  
Vijay Viswanathan ◽  
Kannan Thiruvengadam ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Treatment Outcomes ◽  
Validation Cohort ◽  
High Sensitivity ◽  
Sputum Smear ◽  
Newly Diagnosed ◽  
Characteristic Analysis ◽  
Increased Risk ◽  
Culture Positive ◽  
Culture Conversion

Abstract Background Plasma chemokines are biomarkers of greater disease severity, higher bacterial burden and delayed sputum culture conversion in pulmonary tuberculosis (PTB). Whether plasma chemokines could also serve as biomarkers of unfavorable treatment outcomes in PTB is not known. Methods A cohort of newly diagnosed, sputum smear and culture positive adult individuals with drug-sensitive PTB were recruited under the Effect of diabetes on Tuberculosis Severity study in Chennai, India. Plasma chemokine levels measured before treatment initiation were compared between 68 cases with unfavorable outcomes (treatment failure, death or recurrence) and 136 control individuals who had recurrence-free cure. A second validation cohort comprising of newly diagnosed, culture positive adults with drug-sensitive TB was used to measure plasma chemokine levels in 20 cases and 40 controls. Findings Six chemokines (CCL2, CCL3, CCL4, CXCL8, CXCL10 and CX3CL1) were associated with increased risk, while CXCL1 was associated with decreased risk of unfavorable outcomes in unadjusted and adjusted analyses in the test cohort. Similarly, CCL3, CXCL8 and CXCL10 were associated with increased risk of unfavorable treatment outcomes in the validation cohort. Receiver operating characteristic analysis revealed combinations of CCL3, CXCL8 and CXCL10 exhibited very high sensitivity and specificity in differentiating cases versus controls. Conclusions Our study reveals a plasma chemokine signature that can be used as a novel biomarker for predicting adverse treatment outcomes in PTB.

scholarly journals 794. Infectivity of Smear-Positive Pulmonary TB After 2 Weeks of Rifampicin-based Anti-Tuberculous Therapy

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S285-S286
Author(s):  
Faraj Alhowady ◽  
Nada Elmaki ◽  
Maisa Ali ◽  
Ahmad Husain ◽  
Muna Al-Maslamani ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Conversion Rate ◽  
Clinical Characteristics ◽  
Communicable Disease ◽  
Sputum Culture ◽  
Sputum Smear ◽  
P Value ◽  
Duration Of Symptoms ◽  
Pulmonary Tb ◽  
Culture Conversion

Abstract Background Pulmonary tuberculosis (TB) remains one of the leading infectious causes of morbidity and mortality worldwide. Most data showed that infectiousness of pulmonary TB diminishes rapidly after 2 weeks of effective anti-tuberculous therapy and the bacilli seen in the smear after 2 weeks are most likely nonviable. We aim to assess this hypothesis by doing sputum culture after 2 weeks of therapy to assess the viability of the bacilli in the smear. Methods A prospective cohort study was conducted on patients admitted to Communicable Disease Centre (CDC), Qatar with smear positive pulmonary tuberculosis during the period November 2013–November 2014. We repeated sputum smear and culture after 2 weeks of rifampicin based regimen to assess the infectivity. Demographic and clinical characteristics of patients was evaluated and compared with smear and culture conversion rate. Results Ninety-five cases were included in the study. All had sputum smear and culture after 2 weeks of supervised rifampicin based therapy (Table 1). Sputum culture at two weeks of treatment was positive in 91 cases (95.7%) and only four cases were culture negative after 2 weeks. Demographic and clinical characteristics were compared with the culture status after 2 weeks, found Patient from Indian subcontinent and symptoms duration more than 1 month are less likely to clear infection after 2 weeks with P-value 0.01 and 0.009, respectively (Table 2). The calculated mean for sputum smear and culture conversion rate was 4 and 8 weeks, respectively. The presence of cough and the duration of symptoms were associated significantly with rapid sputum conversion (P &lt; 0.05); however, the presence of cavity on CXR had no statistical significant effect (Table 3). Conclusion Majority of our patients in the study have positive TB culture after two weeks of rifampicin based anti-tuberculosis therapy. So, discontinuation of the isolation after 2 weeks of treatment assuming that bacilli in the smear are nonviable may not be safe. Disclosures All authors: No reported disclosures.

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