采用诱导痰样本评估充分治疗下肺结核的传染期
Duration of Pulmonary Tuberculosis Infectiousness under Adequate Therapy, as Assessed Using Induced Sputum Samples.
作者信息
Ko Yousang, Shin Jeong Hwan, Lee Hyun-Kyung, Lee Young Seok, Lee Suh-Young, Park So Young, Mo Eun-Kyung, Kim Changhwan, Park Yong Bum
机构信息
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.; Lung Research Institute, Hallym University College of Medicine, Chuncheon, Korea.; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Department of Laboratory Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
出版信息
Tuberc Respir Dis (Seoul). 2017 Jan;80(1):27-34. doi: 10.4046/trd.2017.80.1.27. Epub 2016 Dec 30.
BACKGROUND
A sputum culture is the most reliable indicator of the infectiousness of pulmonary tuberculosis (PTB); however, a spontaneous sputum specimen may not be suitable. The aim of this study was to evaluate the infectious period in patients with non-drug-resistant (DR) PTB receiving adequate standard chemotherapy, using induced sputum (IS) specimens.
METHODS
We evaluated the duration of infectiousness of PTB using a retrospective cohort design.
RESULTS
Among the 35 patients with PTB, 22 were smear-positive. The rates of IS culture positivity from baseline to the sixth week of anti-tuberculosis medication in the smear-positive PTB group were 100%, 100%, 91%, 73%, 36%, and 18%, respectively. For smear-positive PTB cases, the median time of conversion to culture negativity was 35.0 days (range, 28.0-42.0 days). In the smear-negative PTB group (n=13), the weekly rates of positive IS culture were 100%, 77%, 39%, 8%, 0%, and 0%, respectively, and the median time to conversion to culture-negative was 21.0 days (range, 17.5-28.0 days).
CONCLUSION
The infectiousness of PTB, under adequate therapy, may persist longer than previously reported, even in patients with non-DR PTB.
背景
痰培养是肺结核（PTB）传染性最可靠的指标；然而，自发咳痰标本可能并不合适。本研究旨在使用诱导痰（IS）标本评估接受充分标准化疗的非耐药（DR）PTB患者的传染期。
方法
我们采用回顾性队列设计评估PTB的传染期持续时间。
结果
在35例PTB患者中，22例痰涂片阳性。痰涂片阳性PTB组从基线到抗结核药物治疗第6周的IS培养阳性率分别为100%、100%、91%、73%、36%和18%。对于痰涂片阳性的PTB病例，转为培养阴性的中位时间为35.0天（范围28.0 - 42.0天）。在痰涂片阴性PTB组（n = 13）中，IS培养阳性的周率分别为100%、77%、39%、8%、0%和0%，转为培养阴性的中位时间为21.0天（范围17.5 - 28.0天）。
结论
即使在非DR PTB患者中，充分治疗下PTB的传染性可能比先前报道的持续时间更长。
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