Tuberc Respir Dis.  2018 Jul;81(3):233-240. 10.4046/trd.2017.0096.

Factors Associated with Persistent Sputum Positivity at the End of the Second Month of Tuberculosis Treatment in Lithuania

• Diktanas S
• Vasiliauskiene E
• Polubenko
• Danila E
• Celedinaite I
• Boreikaite E
• Misiunas K

• KMID: 2414566
• DOI: http://doi.org/10.4046/trd.2017.0096

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.

Keyword

Tuberculosis; Risk Factors; Treatment Outcome; Sputum

MeSH Terms

Alcoholism
Anemia
Blood Sedimentation
Body Mass Index
C-Reactive Protein
Diagnosis
Humans
Leukocytosis
Lithuania*
Logistic Models
Male
Risk Factors
Sputum*
Thorax
Thrombocytosis
Treatment Outcome
Tuberculosis*
Tuberculosis, Pulmonary
Unemployment
C-Reactive Protein

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