Impact of emphysema on sputum culture conversion in male patients with pulmonary tuberculosis: a retrospective analysis.
BMC Pulm Med
; 20(1): 287, 2020 Nov 07.
Article
en En
| MEDLINE
| ID: mdl-33160360
ABSTRACT
BACKGROUND:
Although cigarette smoking may have a negative impact on the clinical outcome of pulmonary tuberculosis (PTB), few studies have investigated the impact of smoking-associated lung diseases. Emphysema is a major pathological finding of smoking-related lung damage. We aimed to clarify the effect of emphysema on sputum culture conversion rate for Mycobacterium tuberculosis (MTB).METHODS:
We retrospectively studied 79 male patients with PTB confirmed by acid-fast bacillus smear and culture at Jikei University Daisan Hospital between January 2015 and December 2018. We investigated the sputum culture conversion rates for MTB after starting standard anti-TB treatment in patients with or without emphysema. Emphysema was defined as Goddard score ≥ 1 based on low attenuation area < - 950 Hounsfield Unit (HU) using computed tomography (CT). We also evaluated the effect on PTB-related CT findings prior to anti-TB treatment.RESULTS:
Mycobacterial median time to culture conversion (TCC) in 38 PTB patients with emphysema was 52.0 days [interquartile range (IQR) 29.0-66.0 days], which was significantly delayed compared with that in 41 patients without emphysema (28.0 days, IQR 14.0-42.0 days) (p < 0.001, log-rank test). Multivariate Cox proportional hazards analysis showed that the following were associated with delayed TCC emphysema [hazard ratio (HR) 2.43; 95% confidence interval (CI) 1.18-4.97; p = 0.015), cavities (HR 2.15; 95% CI 1.83-3.89; p = 0.012) and baseline time to TB detection within 2 weeks (HR 2.95; 95% CI 1.64-5.31; p < 0.0001). Cavities and consolidation were more often identified by CT in PTB patients with than without emphysema (71.05% vs 43.90%; p = 0.015, and 84.21% vs 60.98%; p = 0.021, respectively).CONCLUSIONS:
This study suggests that emphysema poses an increased risk of delayed TCC in PTB. Emphysema detection by CT might be a useful method for prediction of the duration of PTB treatment required for sputum negative conversion.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Enfisema Pulmonar
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Esputo
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Tuberculosis Pulmonar
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Fumar Cigarrillos
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Mycobacterium tuberculosis
Tipo de estudio:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Aged80
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Humans
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Male
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Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
BMC Pulm Med
Año:
2020
Tipo del documento:
Article
País de afiliación:
Japón