In patients with pulmonary tuberculosis (TB), shortening the
time to sputum culture conversion is desirable to reduce the likelihood of
mycobacterial transmission. A persistent positive sputum culture after 2 months
of treatment is reported to be associated with the presence of cavitation and
the extent of disease on chest X-ray, high colony count, diabetes mellitus, and
smoking. However, little is known about factors affecting the time to sputum
culture conversion. This study was conducted to evaluate factors affecting the
time to sputum culture conversion throughout the course of treatment in adults
with pulmonary TB.
This study was performed using a database of the medical
records of patients with active pulmonary TB who were treated at Hirakata
Kohsai Hospital in Hirakata City, Osaka, Japan, from October 2000 to October
2002. Cox proportional-hazards analysis was used to evaluate factors affecting
the time to sputum culture conversion after adjusting for potential
confounders.
The data of 86 patients with pulmonary TB were analyzed. The
median time to sputum culture conversion was 39 days, and the maximum time was
116 days. The Cox proportional-hazards analysis showed that a higher smear
grading (HR, 0.40; 95%CI, 0.23–0.71) and a history of ever smoking (HR, 0.48;
95%CI, 0.25–0.94) were associated with delayed sputum culture conversion.
High smear grading and smoking prolonged the time to sputum
culture conversion in adults with pulmonary TB. To effectively control TB,
measures to decrease the cigarette smoking rate should be implemented, in
addition to early detection and timely anti-TB treatment.
Below: Kaplan-Meier Curve of the time to sputum culture conversion for all patients
Full article at: http://goo.gl/DI9w5U
By:
Rie Kanda, Taishi Nagao, Nguyen Van Tho, Yasutaka Nakano
Division of Respiratory
Medicine, Department of Medicine, Shiga University of Medical Science, Shiga,
Japan
Emiko Ogawa
Health Administration Center,
Shiga University of Medical Science, Shiga, Japan
Yoshitaka Murakami
Department of Medical
Statistics, Shiga University of Medical Science, Shiga, Japan
Makoto Osawa
Division of Infection Control
and Prevention, Shiga University of Medical Science Hospital, Shiga, Japan
Yoshinori Saika
Department of Radiology,
Hirakata Kohsai Hospital, Osaka, Japan
Kenji Doi
Department of Radiology,
Morinomiya Hospital, Osaka, Japan
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