A Retrospective Comparative Study on Median Time to Sputum Culture Conversion in Multi-Drug Resistant Pulmonary Tuberculosis Patients in Pastoral and Non-Pastoral Settings in Southeast Oromia, Ethiopia

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.

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Factors Affecting Time to Sputum Culture Conversion in Adults with Pulmonary Tuberculosis: A Historical Cohort Study without Censored Cases

PLoS ONE ◽

10.1371/journal.pone.0142607 ◽

2015 ◽

Vol 10 (11) ◽

pp. e0142607 ◽

Cited By ~ 15

Author(s):

Rie Kanda ◽

Taishi Nagao ◽

Nguyen Van Tho ◽

Emiko Ogawa ◽

Yoshitaka Murakami ◽

...

Keyword(s):

Cohort Study ◽

Pulmonary Tuberculosis ◽

Sputum Culture ◽

Historical Cohort ◽

Factors Affecting ◽

Sputum Culture Conversion ◽

Historical Cohort Study ◽

Culture Conversion

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Clofazimine for Treatment of Extensively Drug-Resistant Pulmonary Tuberculosis in China

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.02149-17 ◽

2018 ◽

Vol 62 (4) ◽

Cited By ~ 5

Author(s):

Qingfeng Wang ◽

Yu Pang ◽

Wei Jing ◽

Yufeng Liu ◽

Na Wang ◽

...

Keyword(s):

Adverse Event ◽

Adverse Events ◽

Sputum Culture ◽

Successful Outcome ◽

Control Group ◽

Drug Resistant ◽

Sputum Culture Conversion ◽

Extensively Drug Resistant ◽

Experimental Group ◽

Culture Conversion

ABSTRACT We performed a multicenter, prospective, randomized study to investigate the efficacy and safety of clofazimine (CLO) for treatment of extensively drug-resistant tuberculosis (XDR-TB) in China. Forty-nine patients infected with XDR-TB were randomly assigned to either the control group or the CLO group, both of which received 36 months of individually customized treatment. The primary endpoint was the time to sputum culture conversion on solid medium. Clinical outcomes of patients were evaluated at the time of treatment completion. Of the 22 patients in the experimental group, 7 (31.8%) met the treatment criterion of “cure” and 1 (4.5%) “complete treatment,” for a total of 8 (36.4%) exhibiting successful treatment outcomes without relapse. In the control group, 6 patients (22.2%) were cured and 6 (22.2%) completed treatment by the end of the study. Statistical analysis revealed no significant difference in successful outcome rates between the CLO group and the control group. The average sputum culture conversion time for the experimental group was 19.7 months, which was not statistically different from that for the control group (20.3 months; P = 0.57). Of the 22 patients in the CLO group, 12 (54.5%) experienced adverse events after starting CLO treatment. The most frequently observed adverse event was liver damage, with 31.8% of patients (7/22 patients) in the CLO group versus 11.1% (3/27 patients) in the control group exhibiting this adverse event. Our study demonstrates that inclusion of CLO in background treatment regimens for XDR-TB is of limited benefit, especially since hepatic disorders arise as major adverse events with CLO treatment. (This study is registered with the Chinese Clinical Trial Registry [ChiCTR, www.chictr.org.cn ] under identifier ChiCTR1800014800.)

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

10.21203/rs.3.rs-41997/v2 ◽

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.

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