毛发中的异烟肼水平可预测肺结核痰培养转阴情况。

Hair isoniazid levels predict TB sputum culture conversion.

作者信息

Muzanyi G, Ntale M, Salata R, Joloba M, Mukonzo J, Mafigiri D, Mubiri P, Bbosa G

机构信息

Department of Pharmacology and Therapeutics, Makerere College of Health Sciences, Kampala, Uganda;, Uganda-Case Western Reserve University Research Collaboration, Kampala, Uganda.

Department of Chemistry, College of Natural Sciences, Makerere University, Kampala, Uganda.

出版信息

Int J Tuberc Lung Dis. 2025 Jan 1;29(1):1-6. doi: 10.5588/ijtld.24.0374.

DOI:10.5588/ijtld.24.0374

PMID:39754284

Abstract

BACKGROUNDSputum culture is the gold standard for diagnosing TB disease and confirming treatment outcomes. However, the turnaround time is 6-8 weeks, which leads to delays in decision-making regarding the care of TB patients.OBJECTIVETo evaluate isoniazid hair drug levels as a predictor of sputum culture conversion at 8 weeks of TB treatment.METHODSWe enrolled 56 TB patients and started them on treatment. We collected sputum and hair samples at baseline and Weeks 4, 8, and 26. Sputum culture was done on solid and liquid media. The hair drug levels assay was done using liquid chromatography-tandem mass spectrometry.RESULTSWe excluded 22 participants (8 with contaminated cultures, 10 were unable to produce sputum, and 4 missed the Week 8 visit). Of the remaining 28, about 24 (86%) were TB sputum culture-negative with a median hair drug level of 0.0514 ng/ml (IQR 0.1165-0.0314), and 4 (14.1%) were TB culture-positive, with a median hair drug level of 0.0192 (IQR 0.0267-0.0132).CONCLUSIONA median isoniazid hair level of ≥0.05 ng/ml may be predictive of sputum culture conversion by the end of the intensive phase of TB treatment..

摘要

背景痰培养是诊断结核病和确认治疗结果的金标准。然而，周转时间为6至8周，这导致在结核病患者护理决策方面出现延迟。目的评估异烟肼毛发药物水平作为结核病治疗8周时痰培养转阴的预测指标。方法我们招募了56名结核病患者并开始对他们进行治疗。我们在基线、第4周、第8周和第26周收集痰液和毛发样本。在固体和液体培养基上进行痰培养。使用液相色谱 - 串联质谱法进行毛发药物水平测定。结果我们排除了22名参与者（8名培养物受污染，10名无法咳出痰液，4名错过第8周随访）。在其余28名中，约24名（86%）痰培养阴性，毛发药物水平中位数为0.0514 ng/ml（四分位间距0.1165 - 0.0314），4名（14.1%）痰培养阳性，毛发药物水平中位数为0.0192（四分位间距0.0267 - 0.0132）。结论异烟肼毛发水平中位数≥0.05 ng/ml可能预测结核病治疗强化期结束时痰培养转阴。