Time to sputum culture conversion and its predictors among patients with multidrug-resistant tuberculosis in Hangzhou, China: A retrospective cohort study
The objective is to investigate the time to initial sputum culture conversion (SCC) and its predictors among multidrug-resistant tuberculosis (MDR-TB) patients in Hangzhou, China.A retrospective cohort study was conducted among patients who initiated MDR-TB treatment from 2011 to 2015 in Hangzhou, C...
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| Veröffentlicht in: | Medicine (Baltimore) 2020-12, Vol.99 (50), p.e23649-e23649 |
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| creator | Li, Qingchun Lu, Min Hsieh, Evelyn Wu, Limin Wu, Yifei Wang, Meng Wang, Le Zhao, Gang Xie, Li Qian, Han-Zhu |
| description | The objective is to investigate the time to initial sputum culture conversion (SCC) and its predictors among multidrug-resistant tuberculosis (MDR-TB) patients in Hangzhou, China.A retrospective cohort study was conducted among patients who initiated MDR-TB treatment from 2011 to 2015 in Hangzhou, China. Successful achievement of initial SCC was defined as 2 consecutive negative cultures taken at least 30 days apart after initiation of treatment of MDR-TB. Successful treatment outcomes included being cured and completing treatment, while poor treatment outcomes included treatment failure, loss to follow-up, and death. Time to initial SCC was analyzed using the Kaplan-Meier method, and Cox proportional hazards regression was used to identify predictors of SCC.Among 384 patients enrolled with MDR-TB, 359 (93.5%) successfully achieved initial SCC after a median of 85 days (interquartile range, 40-112 days). A higher rate of SCC was observed in participants with successful treatment outcomes than those with poor treatment outcomes (P |
| doi_str_mv | 10.1097/MD.0000000000023649 |
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Successful achievement of initial SCC was defined as 2 consecutive negative cultures taken at least 30 days apart after initiation of treatment of MDR-TB. Successful treatment outcomes included being cured and completing treatment, while poor treatment outcomes included treatment failure, loss to follow-up, and death. Time to initial SCC was analyzed using the Kaplan-Meier method, and Cox proportional hazards regression was used to identify predictors of SCC.Among 384 patients enrolled with MDR-TB, 359 (93.5%) successfully achieved initial SCC after a median of 85 days (interquartile range, 40-112 days). A higher rate of SCC was observed in participants with successful treatment outcomes than those with poor treatment outcomes (P<.01). Multivariate analysis showed that age 25 to 64 years (compared with age<25; adjusted odds ratio [AOR], 0.7; 95% confidence interval [CI], 0.5-0.9; P < .01), age ≥65 years (compared with age < 25; AOR, 0.5; 95% CI, 0.3-0.8; P < .01), and household registration in Hangzhou (compared with non-Hangzhou registration; AOR, 1.3; 95% CI, 1.0-1.5; P < .05) were found to be associated with SCC.Although high SCC and treatment success rates were observed among MDR-TB patients in Hangzhou, the prolonged duration to initial SCC underscores the importance of emphasizing measures for infection control. A new policy of shifting outpatient treatment to inpatient treatment in China may reduce the risk of transmission from patients in the time window prior to SCC.]]></description><identifier>ISSN: 0025-7974</identifier><identifier>EISSN: 1536-5964</identifier><identifier>DOI: 10.1097/MD.0000000000023649</identifier><identifier>PMID: 33327347</identifier><language>eng</language><publisher>United States: Lippincott Williams & Wilkins</publisher><subject>Adult ; Age Factors ; Aged ; Antitubercular Agents - administration & dosage ; Antitubercular Agents - therapeutic use ; China ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Medication Adherence - statistics & numerical data ; Middle Aged ; Observational Study ; Proportional Hazards Models ; Residence Characteristics ; Retrospective Studies ; Sex Factors ; Socioeconomic Factors ; Sputum - cytology ; Time Factors ; Tuberculosis, Multidrug-Resistant - drug therapy ; Young Adult</subject><ispartof>Medicine (Baltimore), 2020-12, Vol.99 (50), p.e23649-e23649</ispartof><rights>Lippincott Williams & Wilkins</rights><rights>Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3558-37c9caa5d15b68583ee8095abd91fa27e0a4ac35c4f1bcedf00df5bc88afd5de3</cites><orcidid>0000-0003-2785-2628 ; 0000-0001-6823-5074</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738096/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7738096/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33327347$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Qingchun</creatorcontrib><creatorcontrib>Lu, Min</creatorcontrib><creatorcontrib>Hsieh, Evelyn</creatorcontrib><creatorcontrib>Wu, Limin</creatorcontrib><creatorcontrib>Wu, Yifei</creatorcontrib><creatorcontrib>Wang, Meng</creatorcontrib><creatorcontrib>Wang, Le</creatorcontrib><creatorcontrib>Zhao, Gang</creatorcontrib><creatorcontrib>Xie, Li</creatorcontrib><creatorcontrib>Qian, Han-Zhu</creatorcontrib><title>Time to sputum culture conversion and its predictors among patients with multidrug-resistant tuberculosis in Hangzhou, China: A retrospective cohort study</title><title>Medicine (Baltimore)</title><addtitle>Medicine (Baltimore)</addtitle><description><![CDATA[The objective is to investigate the time to initial sputum culture conversion (SCC) and its predictors among multidrug-resistant tuberculosis (MDR-TB) patients in Hangzhou, China.A retrospective cohort study was conducted among patients who initiated MDR-TB treatment from 2011 to 2015 in Hangzhou, China. Successful achievement of initial SCC was defined as 2 consecutive negative cultures taken at least 30 days apart after initiation of treatment of MDR-TB. Successful treatment outcomes included being cured and completing treatment, while poor treatment outcomes included treatment failure, loss to follow-up, and death. Time to initial SCC was analyzed using the Kaplan-Meier method, and Cox proportional hazards regression was used to identify predictors of SCC.Among 384 patients enrolled with MDR-TB, 359 (93.5%) successfully achieved initial SCC after a median of 85 days (interquartile range, 40-112 days). A higher rate of SCC was observed in participants with successful treatment outcomes than those with poor treatment outcomes (P<.01). Multivariate analysis showed that age 25 to 64 years (compared with age<25; adjusted odds ratio [AOR], 0.7; 95% confidence interval [CI], 0.5-0.9; P < .01), age ≥65 years (compared with age < 25; AOR, 0.5; 95% CI, 0.3-0.8; P < .01), and household registration in Hangzhou (compared with non-Hangzhou registration; AOR, 1.3; 95% CI, 1.0-1.5; P < .05) were found to be associated with SCC.Although high SCC and treatment success rates were observed among MDR-TB patients in Hangzhou, the prolonged duration to initial SCC underscores the importance of emphasizing measures for infection control. A new policy of shifting outpatient treatment to inpatient treatment in China may reduce the risk of transmission from patients in the time window prior to SCC.]]></description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Antitubercular Agents - administration & dosage</subject><subject>Antitubercular Agents - therapeutic use</subject><subject>China</subject><subject>Female</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medication Adherence - statistics & numerical data</subject><subject>Middle Aged</subject><subject>Observational Study</subject><subject>Proportional Hazards Models</subject><subject>Residence Characteristics</subject><subject>Retrospective Studies</subject><subject>Sex Factors</subject><subject>Socioeconomic Factors</subject><subject>Sputum - cytology</subject><subject>Time Factors</subject><subject>Tuberculosis, Multidrug-Resistant - drug therapy</subject><subject>Young Adult</subject><issn>0025-7974</issn><issn>1536-5964</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdUstu1DAUjRCITgtfgIS8ZEGKH_E4YYFUTYEitWJT1pZj30wMiR38mFH5FL62LlPKwxtL957HvT6uqhcEnxLciTdX56f4z6Fs3XSPqhXhbF3zbt08rlalymvRieaoOo7xK8aECdo8rY4YY1SwRqyqn9d2BpQ8iktOeUY6TykHQNq7HYRovUPKGWRTREsAY3XyISI1e7dFi0oWXOnsbRrRXJjWhLytA0Qbk3IJpdxDKJK-FJB16EK57Y_R59doM1qn3qIzFCAFHxfQye7ubEcfEoopm5tn1ZNBTRGe398n1ZcP7683F_Xl54-fNmeXtWactzUTutNKcUN4v255ywBa3HHVm44MigrAqlEFqpuB9BrMgLEZeK_bVg2GG2An1buD7pL7GYwuKwU1ySXYWYUb6ZWV_3acHeXW76QQrDiti8Cre4Hgv2eISc42apgm5cDnKGkjcNt15e0LlB2guiwdAwwPNgTLu1Tl1bn8P9XCevn3hA-c3zEWQHMA7P2USmzfpryHIEdQUxp_6XHR0ZpiigklBNflK9CW3QIt7bPg</recordid><startdate>20201211</startdate><enddate>20201211</enddate><creator>Li, Qingchun</creator><creator>Lu, Min</creator><creator>Hsieh, Evelyn</creator><creator>Wu, Limin</creator><creator>Wu, Yifei</creator><creator>Wang, Meng</creator><creator>Wang, Le</creator><creator>Zhao, Gang</creator><creator>Xie, Li</creator><creator>Qian, Han-Zhu</creator><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2785-2628</orcidid><orcidid>https://orcid.org/0000-0001-6823-5074</orcidid></search><sort><creationdate>20201211</creationdate><title>Time to sputum culture conversion and its predictors among patients with multidrug-resistant tuberculosis in Hangzhou, China: A retrospective cohort study</title><author>Li, Qingchun ; Lu, Min ; Hsieh, Evelyn ; Wu, Limin ; Wu, Yifei ; Wang, Meng ; Wang, Le ; Zhao, Gang ; Xie, Li ; Qian, Han-Zhu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3558-37c9caa5d15b68583ee8095abd91fa27e0a4ac35c4f1bcedf00df5bc88afd5de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Antitubercular Agents - administration & dosage</topic><topic>Antitubercular Agents - therapeutic use</topic><topic>China</topic><topic>Female</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medication Adherence - statistics & numerical data</topic><topic>Middle Aged</topic><topic>Observational Study</topic><topic>Proportional Hazards Models</topic><topic>Residence Characteristics</topic><topic>Retrospective Studies</topic><topic>Sex Factors</topic><topic>Socioeconomic Factors</topic><topic>Sputum - cytology</topic><topic>Time Factors</topic><topic>Tuberculosis, Multidrug-Resistant - drug therapy</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Qingchun</creatorcontrib><creatorcontrib>Lu, Min</creatorcontrib><creatorcontrib>Hsieh, Evelyn</creatorcontrib><creatorcontrib>Wu, Limin</creatorcontrib><creatorcontrib>Wu, Yifei</creatorcontrib><creatorcontrib>Wang, Meng</creatorcontrib><creatorcontrib>Wang, Le</creatorcontrib><creatorcontrib>Zhao, Gang</creatorcontrib><creatorcontrib>Xie, Li</creatorcontrib><creatorcontrib>Qian, Han-Zhu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Medicine (Baltimore)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Qingchun</au><au>Lu, Min</au><au>Hsieh, Evelyn</au><au>Wu, Limin</au><au>Wu, Yifei</au><au>Wang, Meng</au><au>Wang, Le</au><au>Zhao, Gang</au><au>Xie, Li</au><au>Qian, Han-Zhu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Time to sputum culture conversion and its predictors among patients with multidrug-resistant tuberculosis in Hangzhou, China: A retrospective cohort study</atitle><jtitle>Medicine (Baltimore)</jtitle><addtitle>Medicine (Baltimore)</addtitle><date>2020-12-11</date><risdate>2020</risdate><volume>99</volume><issue>50</issue><spage>e23649</spage><epage>e23649</epage><pages>e23649-e23649</pages><issn>0025-7974</issn><eissn>1536-5964</eissn><abstract><![CDATA[The objective is to investigate the time to initial sputum culture conversion (SCC) and its predictors among multidrug-resistant tuberculosis (MDR-TB) patients in Hangzhou, China.A retrospective cohort study was conducted among patients who initiated MDR-TB treatment from 2011 to 2015 in Hangzhou, China. Successful achievement of initial SCC was defined as 2 consecutive negative cultures taken at least 30 days apart after initiation of treatment of MDR-TB. Successful treatment outcomes included being cured and completing treatment, while poor treatment outcomes included treatment failure, loss to follow-up, and death. Time to initial SCC was analyzed using the Kaplan-Meier method, and Cox proportional hazards regression was used to identify predictors of SCC.Among 384 patients enrolled with MDR-TB, 359 (93.5%) successfully achieved initial SCC after a median of 85 days (interquartile range, 40-112 days). A higher rate of SCC was observed in participants with successful treatment outcomes than those with poor treatment outcomes (P<.01). Multivariate analysis showed that age 25 to 64 years (compared with age<25; adjusted odds ratio [AOR], 0.7; 95% confidence interval [CI], 0.5-0.9; P < .01), age ≥65 years (compared with age < 25; AOR, 0.5; 95% CI, 0.3-0.8; P < .01), and household registration in Hangzhou (compared with non-Hangzhou registration; AOR, 1.3; 95% CI, 1.0-1.5; P < .05) were found to be associated with SCC.Although high SCC and treatment success rates were observed among MDR-TB patients in Hangzhou, the prolonged duration to initial SCC underscores the importance of emphasizing measures for infection control. A new policy of shifting outpatient treatment to inpatient treatment in China may reduce the risk of transmission from patients in the time window prior to SCC.]]></abstract><cop>United States</cop><pub>Lippincott Williams & Wilkins</pub><pmid>33327347</pmid><doi>10.1097/MD.0000000000023649</doi><orcidid>https://orcid.org/0000-0003-2785-2628</orcidid><orcidid>https://orcid.org/0000-0001-6823-5074</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wolters Kluwer Open Health; MEDLINE; DOAJ Directory of Open Access Journals; IngentaConnect Free/Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Adult Age Factors Aged Antitubercular Agents - administration & dosage Antitubercular Agents - therapeutic use China Female Humans Kaplan-Meier Estimate Male Medication Adherence - statistics & numerical data Middle Aged Observational Study Proportional Hazards Models Residence Characteristics Retrospective Studies Sex Factors Socioeconomic Factors Sputum - cytology Time Factors Tuberculosis, Multidrug-Resistant - drug therapy Young Adult |
| title | Time to sputum culture conversion and its predictors among patients with multidrug-resistant tuberculosis in Hangzhou, China: A retrospective cohort study |
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