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KMID : 1044520180810030233
Tuberculosis and Respiratory Diseases
2018년 81권 3호 p.233 ~ p.240

Factors Associated with Persistent Sputum Positivity at the End of the Second Month of Tuberculosis Treatment in Lithuania
 ( Diktanas Saulius ) - Vilnius University Hospital Santariskiu Klinikos Center of Pulmonology and Allergology

 ( Vasiliauskiene Edita ) - Vilnius University Hospital Santariskiu Klinikos Center of Laboratory Medicine
 ( Polubenko Katazyna ) - Vilnius University Faculty of Medicine
 ( Danila Edvardas ) - Vilnius University Hospital Santariskiu Klinikos Center of Pulmonology and Allergology
 ( Celedinaite Indre ) - Vilnius University Faculty of Medicine
 ( Boreikaite Evelina ) - Vilnius University Faculty of Medicine
 ( Misiunas Kipras ) - Vilnius University Faculty of Medicine
- Abstract -
Background: Non-conversion of sputum smear and culture prolongs the infectivity of the patient and has been associated with unfavorable outcomes. We aimed to evaluate factors associated with persistent sputum positivity at the end of two months of treatment of new case pulmonary tuberculosis (TB).

Methods: Data of 87 human immunodeficiency virus-negative patients with culture-positive drug-susceptible pulmonary TB admitted to local university hospital between September 2015 and September 2016 were reviewed. Factors associated with sputum smear and/or culture positivity at the end of the second month of treatment were analyzed.

Results: Twenty-two patients (25.3%) remained smear and/or culture-positive. Male sex, lower body mass index (BMI), unemployment, alcohol abuse, higher number of lobes involved and cavities on chest X-rays, shorter time to detection (TTD) on liquid cultures, higher respiratory sample smear grading and colony count in solid cultures, higher C-reactive protein, erythrocyte sedimentation rate, leukocytosis, thrombocytosis, and anemia were all significantly associated with persistent sputum positivity. However, in the logistic regression analysis only male sex, lower BMI, alcohol abuse, higher radiological involvement, cavitation, higher smear grading, higher colony count in solid cultures and shorter TTD were determined as independent factors associated with persistent sputum positivity at the end of 2 months of treatment.

Conclusion: In conclusion, higher sputum smear and culture grading at diagnosis, shorter TTD, higher number of lobes involved, cavitation, male sex, alcohol abuse, and lower BMI were independently associated with persistent sputum positivity. These factors should be sought when distinguishing which patients will remain infectious longer and possibly have worse outcomes.
- Key Words -

Tuberculosis, Risk Factors, Treatment Outcome, Sputum
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