Qing Chen, Wei He, Juan Du, Wanli Kang, Liping Zou, Xianzhen Tang, Peijun Tang, Chunhui Guo, Qing Pan, Qingdong Zhu, Song Yang, Zhouli Guo, Guihui Wu, Shenjie Tang
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We mainly used logistic regression model to derive possible predictors of early and interim culture conversion.</p><p><strong>Results: </strong>A total of 813 patients were enrolled and 28.5% of them received multidrug-resistant treatment regimens containing bedaquiline. Of these, 362 (44.5%) patients experienced culture conversion within 2 months of treatment, and 649 (79.8%) within 6 months. The results of the multivariable logistic regression analysis revealed that acid-fast bacilli smear positive (adjusted odds ratio [aOR] = 1.637, 95% confidence interval [CI] = 1.197-2.238), cavities (aOR = 1.539, 95% CI = 1.132-2.092), bilateral disease (aOR = 1.638, 95% CI = 1.183-2.269), and viral hepatitis (aOR = 2.585, 95% CI = 1.189-5.622) were identified as risk factors for early culture un-conversion within 2 months of treatment. Additionally, smoking history (aOR = 2.197, 95% CI = 1.475-3.273), previous treatment for tuberculosis (aOR = 1.909, 95% CI = 1.282-2.844), bilateral disease (aOR = 2.201, 95% CI = 1.369-3.537), viral hepatitis (aOR = 2.329, 95% CI = 1.094-4.962) were identified as risk factors for interim culture un-conversion within 6 months of treatment, while patients with regimen containing bedaquiline (aOR = 0.310, 95% CI = 0.191-0.502) was a protective factor.</p><p><strong>Conclusions: </strong>A history of smoking, a baseline sputum AFB smear positive, lung cavities, bilateral disease, previous anti-tuberculosis treatment, or a comorbidity of viral hepatitis can be used as the predictors for early and interim culture un-conversion in MDR/RR-TB patients, while bedaquiline was a protective factor .</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":null,"pages":null},"PeriodicalIF":4.8000,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481364/pdf/","citationCount":"0","resultStr":"{\"title\":\"Predictors of early and interim culture un-conversion in multidrug-resistant/rifampicin-resistant tuberculosis: a retrospective multi-center cohort study in China.\",\"authors\":\"Qing Chen, Wei He, Juan Du, Wanli Kang, Liping Zou, Xianzhen Tang, Peijun Tang, Chunhui Guo, Qing Pan, Qingdong Zhu, Song Yang, Zhouli Guo, Guihui Wu, Shenjie Tang\",\"doi\":\"10.1186/s13756-024-01480-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>We aimed to evaluate the predictors for early and interim culture conversion within 2 months and 6 months of treatment in multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) patients in China.</p><p><strong>Methods: </strong>This study included adult MDR/RR-TB patients with a positive baseline sputum culture from 8 institutions located in different cities in China from May 2018 to January 2022. 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引用次数: 0
摘要
背景：我们旨在评估中国耐多药/耐利福平肺结核（MDR/RR-TB）患者在治疗2个月和6个月内早期和中期痰培养转阴的预测因素：本研究纳入了2018年5月至2022年1月期间来自中国不同城市8家机构的基线痰培养阳性的成年MDR/RR-TB患者。我们主要采用逻辑回归模型得出早期和中期培养转阴的可能预测因素：共有813名患者入组，其中28.5%的患者接受了含有贝达喹啉的耐多药治疗方案。其中，362 例（44.5%）患者在治疗 2 个月内经历了培养转换，649 例（79.8%）患者在 6 个月内经历了培养转换。多变量逻辑回归分析结果显示，酸性革兰氏染色阳性（调整赔率 [aOR] = 1.637，95% 置信区间 [CI] = 1.197-2.238）、龋齿（aOR = 1.539，95% CI = 1.132-2.092）、双侧疾病（aOR = 1.638，95% CI = 1.183-2.269）和病毒性肝炎（aOR = 2.585，95% CI = 1.189-5.622）被确定为治疗后 2 个月内早期培养未转阴的危险因素。此外，吸烟史（aOR = 2.197，95% CI = 1.475-3.273）、曾接受结核病治疗（aOR = 1.909，95% CI = 1.282-2.844）、双侧疾病（aOR = 2.201，95% CI = 1.369-3.537）、病毒性肝炎（aOR = 2.329，95% CI = 1.094-4.962）被认为是治疗后 6 个月内中期培养未转阴的风险因素，而使用含有贝达喹啉的治疗方案的患者（aOR = 0.310，95% CI = 0.191-0.502）是一个保护因素：吸烟史、基线痰 AFB 涂片阳性、肺空洞、双侧疾病、既往接受过抗结核治疗或合并病毒性肝炎可作为 MDR/RR-TB 患者早期和中期培养未转阴的预测因素，而贝达喹啉是一个保护因素。
Predictors of early and interim culture un-conversion in multidrug-resistant/rifampicin-resistant tuberculosis: a retrospective multi-center cohort study in China.
Background: We aimed to evaluate the predictors for early and interim culture conversion within 2 months and 6 months of treatment in multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) patients in China.
Methods: This study included adult MDR/RR-TB patients with a positive baseline sputum culture from 8 institutions located in different cities in China from May 2018 to January 2022. We mainly used logistic regression model to derive possible predictors of early and interim culture conversion.
Results: A total of 813 patients were enrolled and 28.5% of them received multidrug-resistant treatment regimens containing bedaquiline. Of these, 362 (44.5%) patients experienced culture conversion within 2 months of treatment, and 649 (79.8%) within 6 months. The results of the multivariable logistic regression analysis revealed that acid-fast bacilli smear positive (adjusted odds ratio [aOR] = 1.637, 95% confidence interval [CI] = 1.197-2.238), cavities (aOR = 1.539, 95% CI = 1.132-2.092), bilateral disease (aOR = 1.638, 95% CI = 1.183-2.269), and viral hepatitis (aOR = 2.585, 95% CI = 1.189-5.622) were identified as risk factors for early culture un-conversion within 2 months of treatment. Additionally, smoking history (aOR = 2.197, 95% CI = 1.475-3.273), previous treatment for tuberculosis (aOR = 1.909, 95% CI = 1.282-2.844), bilateral disease (aOR = 2.201, 95% CI = 1.369-3.537), viral hepatitis (aOR = 2.329, 95% CI = 1.094-4.962) were identified as risk factors for interim culture un-conversion within 6 months of treatment, while patients with regimen containing bedaquiline (aOR = 0.310, 95% CI = 0.191-0.502) was a protective factor.
Conclusions: A history of smoking, a baseline sputum AFB smear positive, lung cavities, bilateral disease, previous anti-tuberculosis treatment, or a comorbidity of viral hepatitis can be used as the predictors for early and interim culture un-conversion in MDR/RR-TB patients, while bedaquiline was a protective factor .
期刊介绍：
Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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