Risk Factors and Duration of Smear-Positive and Culture Negative Status in Patients with Sputum Smear-Positive Pulmonary Tuberculosis - Abstract
Objective: The detection of smear-positive and culture-negative (SPCN) status during pulmonary tuberculosis treatment can be seen at a constant rate. However, its risk factors and duration of detection have not been well evaluated with short-interval follow-up of sputum examinations. Methods and Materials: We retrospectively accumulated patients with sputum smear-positive pulmonary tuberculosis who were admitted to National Hospital Organization Wakayama Hospital in Japan from April 2018 to March 2021. The factors associated with the incidence and detection period of SPCN in sputum were analyzed with weekly sputum examinations by a multiple regression analysis.Results: Among the 122 patients with pulmonary tuberculosis who were hospitalized and treated for sputum smear-positive disease, 103 (84.4%) had SPCN status. Risk factors for SPCN detection included female gender and high initial smear grade. The median duration of SPCN status was 35.5 days (range
7-76 days). Risk factors for prolonged SPCN duration included a high initial smear grade, the presence of cavities, and extensive lesions.Conclusion: In a short-interval follow-up of sputum, a very large number of patients were found to have SPCN status. The severity of infection was related to the duration of SPCN detection