易患和 M/XDR-TB 患者中的吸烟行为和文化转变。

Cigarette smoking and culture conversion in patients with susceptible and M/XDR-TB.

机构信息

Division of Clinical Infectious Diseases, Research Centre Borstel, Borstel, German Centre for Infection Research (DZIF), Partner site Hamburg-Lübeck-Borstel, International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany.

Department of Pulmonary Medicine, Institute of Nuclear Medicine and Endocrinology, Kepler University Hospital, Linz, Austria.

出版信息

Int J Tuberc Lung Dis. 2019 Jan 1;23(1):93-98. doi: 10.5588/ijtld.18.0354.

DOI:10.5588/ijtld.18.0354

PMID:30674380

Abstract

BACKGROUND

Tuberculosis (TB) is a leading cause of morbidity and mortality worldwide. Active cigarette smoking may have a significant impact on treatment responses to anti-tuberculosis treatment.

OBJECTIVE

To ascertain the effect of smoking on sputum culture conversion rates following treatment initiation in patients with susceptible, multidrug-resistant and extensively drug-resistant TB (M/XDR-TB).

METHOD

Sputum cultures of smoking and non-smoking patients with pulmonary TB (PTB) treated at a referral centre in Germany were evaluated.

RESULTS

Between January 2012 and March 2017, 247 patients with PTB treated at the Medical Clinic of Research Center Borstel, Borstel, Germany, were included in the study. Of 247 patients, 65 (26.3%) were infected with multidrug-resistant strains of (MDR-TB). Sputum culture examinations were performed on a weekly basis. Active smoking ( 111; time to culture conversion [TCC] 50.7 days, interquartile range [IQR] 26.5-73.0) and former smoking ( 72; TCC 43.1 days, IQR 19.8-56.0) significantly delayed culture conversion rates ( < 0.001) when compared with never smoking ( = 64; TCC 33.2 days, IQR 8.0-50.3). Delay in TCC among smoking, non-MDR-TB patients ( = 138; TCC 47.3 days, IQR 19.0-89.0) was comparable with non-smoking, MDR-TB patients ( = 20; TCC 53.0 days, IQR 18.0-71.0). The shortest TCC was observed in non-smoking, non-MDR-TB patients ( = 44; TCC 33.0 days, IQR 10.0-48.5), whereas the longest was seen in smoking, MDR-TB patients ( = 45; TCC 60.7 days, IQR 33.3-89.0); < 0.001).

CONCLUSION

Active cigarette smoking and, to a lesser extent, former cigarette smoking, substantially delayed culture conversion in PTB.

摘要

背景

结核病（TB）是全球发病率和死亡率的主要原因。主动吸烟可能对抗结核治疗的治疗反应产生重大影响。

目的

确定吸烟对敏感、耐多药和广泛耐药结核病（M/XDR-TB）患者治疗开始后痰培养转换率的影响。

方法

评估在德国一家转诊中心接受治疗的吸烟和非吸烟肺结核（PTB）患者的痰培养。

结果

2012 年 1 月至 2017 年 3 月，德国博尔斯特尔研究中心医学诊所收治了 247 例 PTB 患者。247 例患者中，65 例（26.3%）感染了耐多药菌株（MDR-TB）。每周进行痰培养检查。主动吸烟（111 例；培养转换时间 [TCC] 50.7 天，四分位距 [IQR] 26.5-73.0）和既往吸烟（72 例；TCC 43.1 天，IQR 19.8-56.0）显著延迟了培养转化率（<0.001）与从不吸烟（=64 例；TCC 33.2 天，IQR 8.0-50.3）相比。吸烟、非 MDR-TB 患者的 TCC 延迟（=138 例；TCC 47.3 天，IQR 19.0-89.0）与非吸烟、MDR-TB 患者的 TCC 相似（=20 例；TCC 53.0 天，IQR 18.0-71.0）。最短的 TCC 见于从不吸烟、非 MDR-TB 患者（=44 例；TCC 33.0 天，IQR 10.0-48.5），而最长的见于吸烟、MDR-TB 患者（=45 例；TCC 60.7 天，IQR 33.3-89.0）；<0.001）。