Predictors of Sputum Culture Conversion Among Patients With Tuberculosis in the Era of Tuberculosis Resurgence

Liu, Zhiyuan; Shilkret, Kenneth L.; Ellis, Herman M.

doi:10.1001/archinte.159.10.1110

Cited by 32 publications

(35 citation statements)

References 21 publications

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“…Knowing the risk factors associated with delayed culture conversion helps us to identify the patients that require the most medical resources and attention, such as prolonged respiratory isolation. Several previous studies have evaluated the factors that lead to a delay in sputum culture conversion [11][12][13][14]. Although the definition of sputum conversion and schedules for sputum monitoring varied in each study, cavitary disease and numerous AFB on the initial smears were the most frequently identified factors.…”

Section: Discussionmentioning

confidence: 99%

“…The patients enrolled in this study were prospectively followed up until they had completed treatment. 2-month sputum culture conversion was defined as all collected sputum at 2 months being culturenegative for MTB, and there being no positive cultures thereafter until completion of the anti-TB treatment [11]. The sensitivity and specificity of the 2-month sputum AFB smears were calculated according to the results of the sputum cultures.…”

Section: Treatment Of Ptbmentioning

confidence: 99%

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Role of 2-month sputum smears in predicting culture conversion in pulmonary tuberculosis

Jy²,

Yc³

et al. 2010

European Respiratory Journal

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Sputum smears and culture conversion are frequently used to evaluate treatment response in pulmonary tuberculosis patients. Limited data are available on the evaluation of the correlation between under-treatment sputum smear results and culture conversion.This prospective study included sputum culture-proven pulmonary tuberculosis patients at six hospitals in Taiwan. At least two sets of sputum were collected at the completion of 8 weeks of TB treatment. The sensitivities and specificities of 2-month sputum smears were estimated based on culture conversion status.A total of 371 patients were enrolled for analysis. Factors associated with culture conversion included having a smear positive before treatment, presence of a cavity on radiography, rifampicin resistance and usage of the DOTS (directly observed therapy, short course) strategy. The sensitivities of 2-month sputum smears for culture conversion among all patients, initially smear-positive patients and initially smear-negative patients were 64.3, 71.4 and 38%, respectively, and the specificities were 81.6, 69.9 and 92.8%, respectively. In patients who were 2-month sputum smear-positive, the 2-month culture conversion rate was 80% if the patients were under DOTS and without cavitary lesions in radiograms.The predictive value of 2-month sputum smears in culture conversion was limited and highly influenced by clinical factors in pulmonary tuberculosis patients.KEYWORDS: Culture, directly observed therapy short course implementation, Mycobacterium tuberculosis, pulmonary tuberculosis, sputum P ulmonary tuberculosis (PTB) is an airborne infectious disease that requires multiple-drug combination therapy and long treatment duration. Despite great advances in molecular diagnosis, sputum cultures of Mycobacterium tuberculosis (MTB) remain the gold standard for PTB diagnosis. After initiation of anti-tuberculosis (anti-TB) treatment, sputum acidfast bacilli (AFB) smears and cultures of MTB are regularly checked during the treatment period and serve as important indicators of treatment response. Achievement of sputum sterilisation, which is determined by sputum culture conversion, is a cardinal index of treatment success. Previous studies have demonstrated that the time to sputum negativity is an important determinant of relapse [1][2][3]. Failure to achieve sputum culture conversion in ,2 months will lead to a worse treatment outcome [4]. Documentation of sputum culture conversion is also recommended as a necessary criterion before completion of anti-TB treatment in current treatment guidelines [5]. Based on the high predictive value of sputum culture conversion in treatment response [4,6,7], identification of the clinical factors that are associated with a lower sputum culture conversion rate is of crucial importance in PTB management [8][9][10].In spite of the high accuracy of sputum culture conversion in the assessment of treatment response, the long yield time limits its usefulness in clinical practice. As a simple and rapid test, sputum smears are fre...

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Section: Discussionmentioning

confidence: 99%

Section: Treatment Of Ptbmentioning

confidence: 99%

Role of 2-month sputum smears in predicting culture conversion in pulmonary tuberculosis

Jy²,

Yc³

et al. 2010

European Respiratory Journal

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“…11 The grading of a positive smear reflects the extent of lesion in a particular patient or size of cavitations as well as being directly proportional to the infectiousness of the case. 12 In this study, the presence of numerous bacilli (3+) on initial pre-treatment sputum smears was a predictor of non conversion of positive sputum smears after two months of anti tuberculosis therapy. These finding is similar to previous studies.…”

Section: Discussionmentioning

confidence: 63%

“…This is similar to some previous studies. 6,12,17 . The treatment outcome was also compared with the initial sputum grading.…”

Section: Discussionmentioning

confidence: 99%

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Association of sputum conversion and outcome with initial smear grading among new smear positive Tuberculosis patients in a Tertiary Health Facility, South East Zone, Nigeria

Nwokeukwu¹

2013

IOSR-JDMS

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Evaluating provider prescribing practices for the treatment of tuberculosis in Virginia, 1995 to 1998: An assessment of educational need

Richardson

2000

Journal of Continuing Education in the Health Professions

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Private tuberculosis care providers were less compliant with CDC-ATS guidelines than public tuberculosis care providers. Because providers did not follow the recommended treatment guidelines universally, it is advised that all tuberculosis care providers in Virginia would benefit from increased education regarding adequate treatment regimens for tuberculosis and the prevention of multidrug-resistant tuberculosis.

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Predictors of Sputum Culture Conversion Among Patients With Tuberculosis in the Era of Tuberculosis Resurgence

Cited by 32 publications

References 21 publications

Role of 2-month sputum smears in predicting culture conversion in pulmonary tuberculosis

Role of 2-month sputum smears in predicting culture conversion in pulmonary tuberculosis

Association of sputum conversion and outcome with initial smear grading among new smear positive Tuberculosis patients in a Tertiary Health Facility, South East Zone, Nigeria

Evaluating provider prescribing practices for the treatment of tuberculosis in Virginia, 1995 to 1998: An assessment of educational need

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