Association between Body Mass Index and Sputum Culture Conversion among South Korean Patients with Multidrug Resistant Tuberculosis in a Tuberculosis Referral Hospital

Abstract

BackgroundMultidrug-resistant tuberculosis (MDR-TB) is an important global health problem. Furthermore, the time to identify a positive sputum culture is an important risk factor for the spread of tuberculosis, and several factors can predict a prolonged time to culture conversion. Moreover, the relationship between poor nutritional status and infectious disease is clearly established. Therefore, the present study aimed to investigate the association between body mass index (BMI) and sputum culture conversion within 3 months among patients with MDR-TB.Materials and MethodsWe retrospectively evaluated 218 patients with MDR-TB who were treated at a large tuberculosis referral hospital in South Korea between January 2005 and December 2010. The outcome of interest was defined as sputum culture conversion within 3 months, and we analyzed the association between BMI and this outcome.ResultsAmong the 218 patients, 53 patients (24.3%) had a low BMI (<18.5 kg/m2). In the multivariate Cox proportional-hazards regression analysis, failure to achieve sputum culture conversion within 3 months was independently associated with having a low BMI (hazard ratio [HR]: 1.741, 95% confidence interval [CI]: 1.006–3.013; P = 0.047) and a positive sputum smear at the initiation of therapy (HR: 8.440, 95% CI: 1.146–62.138, P = 0.036).ConclusionLow BMI (<18.5 kg/m2) was an independent risk factor for failure to achieve sputum culture conversion within 3 months among patients with MDR-TB.

Determinants of Multi-Drug Resistant Tuberculosis Among Patients Attending Anti-Tuberculosis Treatment From Peripheral Districts, Southern Ethiopia, 2019: a Case Control Study

“…The respondents with pulmonary TB four times(AOR:3.98) more likely developed MDR-TB than extrapulmonary TB. The nding was in line with study in East shoa (11), Addis Ababa(30),South Korea (28). However, the study in Jimma (13), pulmonary TB had no association with MDR-TB.…”

“…The odds of being body mass index less than 18.5 kg/m 2 were 3 times (AOR:3.11) higher in cases than controls. The nding was in line with other ndings (1,2,28). A poor nutritional status decreases a probability of treatment success (response), increases recurrence, decreases smear conversion rate, reduces hosts immunity by enhancing bacilli development and resistance, and a malnutrition is highly common in MDR-TB patients and one of the risk factors for development of MDR-TB (2,3,8,29).…”

Risk score to predict time-to sputum smear and culture conversions in patients treated with shorter MDR-tuberculosis regime in Guinea (Conakry): A retrospective cohort study.

“…Regardless the MDR-TB treatment regime (12 or 24 months), the WHO recommend the using sputum smear or culture conversion as a proxy marker for a successful MRD-TB treatment outcome [1]. Recently, many efforts have been made to validate these MDR-TB treatment e cacy markers including the optimal time of measurement and the in uencing factors [2][3][4][5][6][7][8][9][10]. One of these studies concluded that the validity of culture conversion is signi cantly higher than sputum smear conversion, and the four months schedule is a common optimal time for culture and smear conversion [10].…”

Management of Pulmonary Tuberculosis Patient With Their Culture Conversion Status in Kendari City, Province of Sulawesi Tenggara, Indonesia

“…Similarly, poor nutrition status according to BMI has been established as a risk factor for pulmonary TB (18). It increases the risk of latent TB infections converting to active TB due to the effects on the immune system of consuming insufficient micro-and macronutrients (protein; vitamins A, D, C, and E; zinc; and selenium) (19,20).…”