scholarly journals Impact of smoking on sputum culture conversion and pulmonary tuberculosis treatment outcomes in Brazil: a retrospective cohort study

2018 ◽  
Vol 44 (2) ◽  
pp. 99-105 ◽  
Author(s):  
Michelle Cailleaux-Cezar ◽  
Carla Loredo ◽  
José Roberto Lapa e Silva ◽  
Marcus Barreto Conde
Keyword(s):  
Cohort Study ◽  
Relative Risk ◽  
Pulmonary Tuberculosis ◽  
Treatment Outcomes ◽  
Retrospective Cohort ◽  
Sputum Culture ◽  
Sputum Culture Conversion ◽  
Poor Treatment ◽  
Never Smokers ◽  
Culture Conversion

ABSTRACT Objective: To evaluate the impact of smoking on pulmonary tuberculosis (PTB) treatment outcomes and the two-month conversion rates for Mycobacterium tuberculosis sputum cultures among patients with culture-confirmed PTB in an area with a moderate incidence of tuberculosis in Brazil. Methods: This was a retrospective cohort study of PTB patients diagnosed and treated at the Thoracic Diseases Institute of the Federal University of Rio de Janeiro between 2004 and 2012. Results: Of the 298 patients diagnosed with PTB during the study period, 174 were included in the outcome analysis: 97 (55.7%) were never-smokers, 31 (17.8%) were former smokers, and 46 (26.5%) were current smokers. Smoking was associated with a delay in sputum culture conversion at the end of the second month of TB treatment (relative risk = 3.58 &091;95% CI: 1.3-9.86&093;; p = 0.01), as well as with poor treatment outcomes (relative risk = 6.29 &091;95% CI: 1.57-25.21&093;; p = 0.009). The association between smoking and a positive culture in the second month of treatment was statistically significant among the current smokers (p = 0.027). Conclusions: In our sample, the probability of a delay in sputum culture conversion was higher in current smokers than in never-smokers, as was the probability of a poor treatment outcome.

scholarly journals Time to sputum culture conversion and its predictors among patients with multidrug resistant tuberculosis in Hangzhou, China: a retrospective cohort study

2019 ◽  
Author(s):  
Qingchun Li ◽  
Min Lu ◽  
Evelyn Hsieh ◽  
Limin Wu ◽  
Yifei Wu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Treatment Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Multidrug Resistant ◽  
Sputum Culture Conversion ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Culture Conversion

Abstract Background To investigate the time to initial sputum culture conversion (SCC) and its predictors among multidrug-resistant tuberculosis (MDR-TB) patients in Hangzhou, China.Methods A retrospective cohort study was conducted among patients initiating treatment for MDR-TB from 2011-2015 in Hangzhou, China. Time to initial SCC was analyzed using the Kaplan-Meier method, and Cox proportional hazards regression was used to identify predictors of SCC.Results Among 384 patients enrolled with MDR-TB, 359 (93.5%) successfully achieved initial SCC after a median of 85 days (inter-quartile range, 40-112 days). A higher rate of SCC was observed in participants with successful treatment outcomes than those with poor treatment outcomes (P<0.01). Multivariate analysis showed that age 25-64 years (adjusted odds ratio [AOR], 0.7; 95% confidence interval [CI], 0.5-0.9; P<0.01), age ≥65 years (AOR, 0.5; 95%CI, 0.3-0.8; P<0.01) and household registration in Hangzhou (AOR, 1.3; 95%CI, 1.0-1.5; P<0.05) were found to be associated with SCC.Conclusions Although high SCC and treatment success rates were observed among MDR-TB patients in Hangzhou, the prolonged duration to initial SCC underscores the importance of emphasizing measures for infection control. A new policy of shifting outpatient treatment to inpatient treatment in China may reduce the risk of transmission from patients in the time window prior to SCC.

scholarly journals Time to Sputum Culture Conversion and Treatment Outcomes Among Patients with Isoniazid-Resistant Tuberculosis in Atlanta, Georgia

2017 ◽  
Vol 65 (11) ◽  
pp. 1862-1871 ◽  
Author(s):  
Marcos C Schechter ◽  
Destani Bizune ◽  
Michelle Kagei ◽  
Mamuka Machaidze ◽  
David P Holland ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Sputum Culture ◽  
Sputum Culture Conversion ◽  
Resistant Tuberculosis ◽  
Culture Conversion

scholarly journals Impact of emphysema on sputum culture conversion in male patients with pulmonary tuberculosis: a retrospective analysis

2020 ◽  
Author(s):  
Naoki Takasaka ◽  
Yoshitaka Seki ◽  
Ikumi Fujisaki ◽  
Shota Uchiyama ◽  
Sachi Matsubayashi ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Pathological Finding ◽  
Sputum Culture ◽  
Sputum Culture Conversion ◽  
Tb Treatment ◽  
Conversion Rates ◽  
Increased Risk ◽  
Male Patients ◽  
The Impact ◽  
Culture Conversion

Abstract Background Although cigarette smoking may have a negative impact on the clinical outcome of pulmonary tuberculosis (PTB), few studies have investigated the impact of smoking-associated lung diseases. Emphysema is a major pathological finding of smoking-related lung damage. We aimed to clarify the effect of emphysema on sputum culture conversion rate for Mycobacterium tuberculosis (MTB). Methods We retrospectively studied 79 male patients with PTB confirmed by acid-fast bacillus smear and culture at Jikei University Daisan Hospital between January 2015 and December 2018. We investigated the sputum culture conversion rates for MTB after starting standard anti-TB treatment in patients with or without emphysema. Emphysema was defined as Goddard score ≥1 based on low attenuation area < -950 Hounsfield Unit (HU) using computed tomography (CT). We also evaluated the effect on PTB-related CT findings prior to anti-TB treatment. Results Mycobacterial median time to culture conversion (TCC) in 38 PTB patients with emphysema was 52.0 days [ interquartile range (IQR) 29.0–66.0 days], which was significantly delayed compared with that in 41 patients without emphysema (28.0 days, IQR 14.0–42.0 days) (p<0.001, log-rank test). Multivariate Cox proportional hazards analysis showed that the following were associated with delayed TCC: emphysema [ hazard ratio (HR): 2.43; 95% confidence interval (CI): 1.18–4.97; p=0.015), cavities (HR: 2.15; 95% CI: 1.83–3.89; p=0.012) and baseline time to TB detection within 2 weeks (HR: 2.95; 95% CI: 1.64–5.31; p<0.0001). Cavities and consolidation were more often identified by CT in PTB patients with than without emphysema (71.05% vs 43.90%; p=0.015 and 84.21% vs 60.98%; p=0.021, respectively). Conclusions This study suggests that emphysema poses an increased risk of delayed TCC in PTB. Emphysema detection by CT might be a useful method for prediction of the duration of PTB treatment required for sputum negative conversion.

scholarly journals Factors associated with sputum culture conversion in patients with pulmonary tuberculosis

Medicina ◽  
2017 ◽  
Vol 53 (6) ◽  
pp. 386-393 ◽  
Author(s):  
Greta Musteikienė ◽  
Skaidrius Miliauskas ◽  
Jurgita Zaveckienė ◽  
Marius Žemaitis ◽  
Astra Vitkauskienė
Keyword(s):  
Pulmonary Tuberculosis ◽  
Sputum Culture ◽  
Sputum Culture Conversion ◽  
Factors Associated ◽  
Culture Conversion

Association of the Clinico-Demographic and Laboratory Profile with Treatment Outcomes in Patients with Drug-Resistant Pulmonary Tuberculosis

2020 ◽  
Vol 16 (1) ◽  
pp. 39-46
Author(s):  
Alam Nawaz ◽  
Manel Arjun Nayak ◽  
Samarth Mahadevappa ◽  
Ashwin Kamath
Keyword(s):  
Platelet Count ◽  
Treatment Outcomes ◽  
Positive Culture ◽  
Public Health Problem ◽  
Sputum Culture ◽  
Drug Resistant ◽  
Sputum Culture Conversion ◽  
The Third ◽  
Pre Treatment ◽  
Culture Conversion

Background: Drug-resistant tuberculosis (DR-TB) is a significant public health problem, especially in the developing and underdeveloped countries; its treatment is relatively expensive, of longer duration, and associated with more adverse effects. Objective: The objective of this study was to report the treatment outcomes in patients with DR-TB and determine if a few selected clinico-demographic parameters and baseline laboratory values, done as part of the pre-treatment evaluation, have any impact on sputum culture conversion and outcomes. The aim was to identify the potential factors associated with unfavourable outcomes prior to starting the treatment. Methods: A retrospective analysis of data of patients diagnosed with DR-TB admitted at our centre from January 2015 to May 2016 was done. Of the 114 patients included, culture reports were available in 85 and 72 patients at the end of the third and sixth month, respectively. The clinicodemographic and laboratory parameters were compared with the sputum culture report at the end of the third and sixth month and final treatment outcomes. Results: Favorable outcome (cured) was seen in 33.3% (38/114) patients. Female gender was associated with delayed sputum culture conversion at three months (P = 0.020). A positive culture at the end of the sixth month was significantly associated with unfavourable outcomes (P = 0.002). A low body mass index (BMI) (15.86 [IQR, 14.10-18.11]) and a higher platelet count (358 × 109/L [IQR, 282-4.85]) at the initiation of treatment were independently and significantly associated with unfavorable outcomes. Conclusion: Patients with a low BMI and high platelet count are more likely to have unfavourable treatment outcomes. Identifying patients with these risk factors during the pre-treatment phase, more intensive follow-up during the treatment course could be advocated.

scholarly journals Impact of emphysema on sputum culture conversion in male patients with pulmonary tuberculosis: a retrospective analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Naoki Takasaka ◽  
Yoshitaka Seki ◽  
Ikumi Fujisaki ◽  
Shota Uchiyama ◽  
Sachi Matsubayashi ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Pathological Finding ◽  
Sputum Culture ◽  
Sputum Culture Conversion ◽  
Tb Treatment ◽  
Conversion Rates ◽  
Increased Risk ◽  
Male Patients ◽  
The Impact ◽  
Culture Conversion

Abstract Background Although cigarette smoking may have a negative impact on the clinical outcome of pulmonary tuberculosis (PTB), few studies have investigated the impact of smoking-associated lung diseases. Emphysema is a major pathological finding of smoking-related lung damage. We aimed to clarify the effect of emphysema on sputum culture conversion rate for Mycobacterium tuberculosis (MTB). Methods We retrospectively studied 79 male patients with PTB confirmed by acid-fast bacillus smear and culture at Jikei University Daisan Hospital between January 2015 and December 2018. We investigated the sputum culture conversion rates for MTB after starting standard anti-TB treatment in patients with or without emphysema. Emphysema was defined as Goddard score ≥ 1 based on low attenuation area < − 950 Hounsfield Unit (HU) using computed tomography (CT). We also evaluated the effect on PTB-related CT findings prior to anti-TB treatment. Results Mycobacterial median time to culture conversion (TCC) in 38 PTB patients with emphysema was 52.0 days [interquartile range (IQR) 29.0–66.0 days], which was significantly delayed compared with that in 41 patients without emphysema (28.0 days, IQR 14.0–42.0 days) (p < 0.001, log-rank test). Multivariate Cox proportional hazards analysis showed that the following were associated with delayed TCC: emphysema [hazard ratio (HR): 2.43; 95% confidence interval (CI): 1.18–4.97; p = 0.015), cavities (HR: 2.15; 95% CI: 1.83–3.89; p = 0.012) and baseline time to TB detection within 2 weeks (HR: 2.95; 95% CI: 1.64–5.31; p < 0.0001). Cavities and consolidation were more often identified by CT in PTB patients with than without emphysema (71.05% vs 43.90%; p = 0.015, and 84.21% vs 60.98%; p = 0.021, respectively). Conclusions This study suggests that emphysema poses an increased risk of delayed TCC in PTB. Emphysema detection by CT might be a useful method for prediction of the duration of PTB treatment required for sputum negative conversion.

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