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Chest Infections |

Evaluation the Decline in Infectiousness of Patients With Pulmonary Ttuberculosis After Receiving Standard Chemotherapy Using Sputum Induction Specimens

Yousang Ko, MD; Junwhi Song, MD
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Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea (the Republic of)


Chest. 2015;148(4_MeetingAbstracts):137A. doi:10.1378/chest.2261494
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Abstract

SESSION TITLE: Chest Infections Posters: Tuberculosis

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: It is known that the infectiousness of pulmonary tuberculosis (PTB) is determined not smear conversion but also culture conversion since smear negative PTB patient contribute to the transmission of TB. The aim of this study was to evaluate the decline in infectiousness of patients with PTB after receiving standard chemotherapy using sputum induction specimens.

METHODS: A retrospective analysis was performed on 69 patients diagnosed with PTB confirmed by culture from 2013 to 2014. Among them, 21 patients were conducted acid fact bacilli stain and culture by induced sputum (IS) at baseline and weekly for 6 weeks. Other 49 patients were conduct AFB stain and culture by IS at 4 weeks after anti-TB therapy. We excluded any drug resistant PTB to the four first-line drugs (isoniazid, rifampicin, ethambutol and Pyrazinamide) based on solid media drug sensitivity test.

RESULTS: In total 69 patients, 59 (85.5%) were new cases, and 10 (14.53%) were previously treated cases; 35 (50.7%) were cavitary PTB; 29 (42.0%) were smear positive PTB. In smear negative 40 PTB patient, the positive rate of culture at 4 weeks after anti-TB therapy was 15.0% and 2.5% in liquid media (LM) and solid media (SM), respectively. In smear positive 29 PTB patients, the positive rate of culture at 4 weeks after anti-TB therapy was 75.9% and 13.8% in LM and SM, respectively. Among 21 patients performed SI weekly after anti-TB therapy, 11 patients were smear positive PTB. In smear positive PTB patients, the positive rate of culture in LM was 100%, 90.9%, 90.9%, 72.7%, 36.4% and 18.2%, respectively. In SM culture of smear positive PTB, the positive culture rate was 100%, 55.6%, 33.3%, 11.1%, 0% and 0%, respectively. In smear negative 10 PTB patients, the positive rate of culture in LM was 100%, 80%, 40%, 10%, 0% and 0%, respectively. In SM culture of smear negative PTB, the positive culture rate was 90%, 20%, 10%, 0%, 0% and 0%, respectively.

CONCLUSIONS: The negative culture conversion in PTB patients after anti-TB therapy takes more times rather than conventionally expected, especially in smear positive PTB. It is need to consider the prolonged infectiousness of PTB despite no drug resistance, in TB treatment and prevention program.

CLINICAL IMPLICATIONS: It is need to consider the prolonged infectiousness of PTB despite no drug resistance, in TB treatment and prevention program.

DISCLOSURE: The following authors have nothing to disclose: Yousang Ko, Junwhi Song

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