Outcome correlation of smear-positivity but culture-negativity during standard anti-tuberculosis treatment in Taiwan

Wen Cheng Chao, Yi Wen Huang, Ming Chih Yu, Wen Ta Yang, Chou Jui Lin, Jen Jyh Lee, Ruay Ming Huang, Chi Chang Shieh, Shun Tien Chien, Jung Yien Chien

研究成果: Article同行評審

4 引文 斯高帕斯(Scopus)

摘要

The appearance of smear-positivity but culture-negativity (SPCN) for acid-fast bacilli among sputum specimen is frequently found in pulmonary tuberculosis (TB) patients during treatment. This study aimed to investigate clinical risk factors, impacts on treatment course, and relapse pattern associated with sputum SPCN. Methods: We retrospectively enrolled 800 patients with culture-proven pulmonary TB who were receiving standard treatment and follow-up at six TB-referral hospitals in Taiwan between January 2006 and December 2007. Relevant patient characteristics and chemotherapy data were analyzed for associations with incidence of SPCN. Data from patients who relapsed within 3 years after completing treatment were analyzed for associations with SPCN during treatment. Results: Of the 800 subjects, 111 (13.8%) had sputum SPCN during treatment. Three factors were found to predict the development of SPCN; namely, high initial acid-fast staining grading (OR, 3.407; 95% CI, 2.090-5.553), cavitation on chest-X ray films (OR, 2.217; 95% CI, 1.359-3.615), and smoking (OR, 1.609; 95% CI, 1.006-2.841). Patients with SPCN had longer treatment duration (rifampicin: 284 ± 91 vs. 235 ± 69 days, <0.001; isoniazid: 289 ± 90 vs. 234 ± 69 days, < 0.001) than those without SPCN. Finally, the rate of relapse within 3 years of completing treatment was similar for groups with/without SPCN (2.7%, 3/111 vs. 1.0%, 7/689, respectively; = 0.15). Conclusions: In conclusion, severity of infection was a major risk factor for SPCN during treatment; however, the relapse rate within 3 years of completing treatment was not affected by the appearance of SPCN.

原文English
文章編號67
期刊BMC infectious diseases
15
發行號1
DOIs
出版狀態Published - 2015 二月 18

All Science Journal Classification (ASJC) codes

  • 傳染性疾病

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