Shah Saeed, Khan Asghar, Shahzad Muhammad, Mokhtar Jawahir A, Harakeh Steve, Kibria Zeeshan, Mehr Aneela, Bano Bushra, Ali Asif, Yousafzai Yasar Mehmood
Institute of Pathology and Diagnostic Medicine, Khyber Medical University, Peshawar 25120, Pakistan.
Institute of Basic Medical Sciences, Khyber Medical University, Peshawar 25120, Pakistan.
Antibiotics (Basel). 2022 Sep 26;11(10):1307. doi: 10.3390/antibiotics11101307.
Mycobacterium tuberculosis infection continues to be a major global challenge. All patients with pulmonary tuberculosis are treated with a standard 6-month treatment regimen. Historical data suggest that even with shortened treatment, most patients achieve long-term remission. Risk stratification is a goal for reducing potentially toxic prolonged treatment. This study aimed to determine the factors associated with the early clearance of sputum acid-fast bacilli (AFB). A total of 297 freshly diagnosed patients with pulmonary tuberculosis were included and enrolled in this study. Information related to their ethno-demographic and anthropometric characteristics was collected. We also assessed their complete blood counts, and blood iron, folate, and vitamin B12 levels. We found that the presence of higher levels of acid-fast bacilli (AFB) in diagnostic sputum microscopy was the single most significant prognostic factor associated with early clearance of sputum AFB after 2 months of treatment. All of our patients achieved treatment success after 6 months of treatment and were disease free. Our results support the data obtained from previous studies indicating that AFB clearance at 2 months is unlikely to be a clinically useful biomarker or indicator for therapeutic stratification. Furthermore, demographic, anthropometric, and nutritional factors are not clinically useful biomarkers.
结核分枝杆菌感染仍然是一项重大的全球挑战。所有肺结核患者均采用标准的6个月治疗方案进行治疗。历史数据表明，即使缩短治疗时间，大多数患者也能实现长期缓解。风险分层是减少潜在毒性延长治疗的目标。本研究旨在确定与痰涂片抗酸杆菌（AFB）早期清除相关的因素。本研究共纳入并登记了297例新诊断的肺结核患者。收集了与他们的种族人口统计学和人体测量学特征相关的信息。我们还评估了他们的全血细胞计数以及血液中铁、叶酸和维生素B12的水平。我们发现，诊断性痰涂片显微镜检查中抗酸杆菌（AFB）水平较高是与治疗2个月后痰涂片AFB早期清除相关的最显著的单一预后因素。我们所有的患者在治疗6个月后均取得了治疗成功且无疾病。我们的结果支持了先前研究获得的数据，表明2个月时AFB清除不太可能成为治疗分层的临床有用生物标志物或指标。此外，人口统计学、人体测量学和营养因素也不是临床有用的生物标志物。
