The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2015
The impact of nutritional state on the duration of sputum positivity of Mycobacterium tuberculosis.
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Hatsuda K, Takeuchi M, Ogata K, Sasaki Y, Kagawa T, Nakatsuji H, Ibaraki M, Sakaguchi M, Kurata M, Hayashi S
Аннотация
BACKGROUND: The outcome of anti-tuberculosis treatment varies according to patient factors.
OBJECTIVE: To retrospectively identify risks related to the extension of time to negative sputum culture (Tn) and to determine their clinical significance.
DESIGN: Patients with bacilli susceptible to isoniazid and rifampicin who received initial standard treatment without cessation were recruited into the study. A total of 630 consecutive in-patients were included in the risk development analysis (development cohort) and another 611 consecutive in-patients in the risk validation analysis (validation cohort).
RESULTS: Univariate analysis showed that Tn was related to sex, body mass index (BMI), white blood cell count (WBC), serum albumin, fasting blood sugar, haemoglobin A1c, C-reactive protein and total cholesterol levels and sputum smear positivity (SSP). Multivariate analysis showed that BMI, WBC and SSP were significant risk factors related to extended Tn. Optimal cut-offs of BMI and WBC for predicting good (Tn < 46 days) and poor responders (Tn ⩾ 46 days) according to each risk were determined by receiver operating characteristics analysis. Risks were verified with the validation cohort. Tn increased according to the number of risks; the median Tn for patients with three risks was 21 days longer than that of patients with none.
CONCLUSION: The nutritional state of a TB patient can be used to predict Tn.
OBJECTIVE: To retrospectively identify risks related to the extension of time to negative sputum culture (Tn) and to determine their clinical significance.
DESIGN: Patients with bacilli susceptible to isoniazid and rifampicin who received initial standard treatment without cessation were recruited into the study. A total of 630 consecutive in-patients were included in the risk development analysis (development cohort) and another 611 consecutive in-patients in the risk validation analysis (validation cohort).
RESULTS: Univariate analysis showed that Tn was related to sex, body mass index (BMI), white blood cell count (WBC), serum albumin, fasting blood sugar, haemoglobin A1c, C-reactive protein and total cholesterol levels and sputum smear positivity (SSP). Multivariate analysis showed that BMI, WBC and SSP were significant risk factors related to extended Tn. Optimal cut-offs of BMI and WBC for predicting good (Tn < 46 days) and poor responders (Tn ⩾ 46 days) according to each risk were determined by receiver operating characteristics analysis. Risks were verified with the validation cohort. Tn increased according to the number of risks; the median Tn for patients with three risks was 21 days longer than that of patients with none.
CONCLUSION: The nutritional state of a TB patient can be used to predict Tn.
Предметные рубрики MeSH
AdolescentAdultAgedAged, 80 and overAntitubercular AgentsBiomarkersBody Mass IndexC-Reactive ProteinFemaleGlucose IntoleranceHumansIsoniazidJapanLeukocytesMaleMiddle AgedMultivariate AnalysisMycobacterium tuberculosisNutritional StatusRetrospective StudiesRifampinRisk FactorsSputumTuberculosisYoung Adult