Diabetes Reduces the Rate of Sputum Culture Conversion in Patients With Newly Diagnosed Multidrug-Resistant Tuberculosis.Report as inadecuate




Diabetes Reduces the Rate of Sputum Culture Conversion in Patients With Newly Diagnosed Multidrug-Resistant Tuberculosis. - Download this document for free, or read online. Document in PDF available to download.

Journal Title:

Open Forum Infectious Diseases

Volume:

Volume 3, Number 3

Publisher:

Oxford University Press OUP | 2016-06-16, Pages ofw126-ofw126

Type of Work:

Article | Final Publisher PDF

Abstract: Background.  Diabetes is a risk factor for active tuberculosis TB, but little is known about the relationship between diabetes and multidrug-resistant MDR TB. We aimed to assess risk factors for primary MDR TB, including diabetes, and determine whether diabetes reduced the rate of sputum culture conversion among patients with MDR TB. Methods.  From 2011 to 2014, we conducted a cohort study at the National Center for Tuberculosis and Lung Diseases in Tbilisi, Georgia. Adult ≥35 years patients with primary TB were eligible. Multidrug-resistant TB was defined as resistance to at least rifampicin and isoniazid. Patients with capillary glycosylated hemoglobin HbA1c ≥ 6.5% or previous diagnosis were defined to have diabetes. Polytomous regression was used to estimate the association of patient characteristics with drug resistance. Cox regression was used to compare rates of sputum culture conversion in patients with and without diabetes. Results.  Among 318 patients with TB, 268 had drug-susceptibility test DST results. Among patients with DST results, 19.4% 52 of 268 had primary MDR TB and 13.4% 36 of 268 had diabetes. In multivariable analyses, diabetes adjusted odds ratio aOR, 2.51; 95% confidence interval CI, 1.00-6.31 and lower socioeconomic status aOR, 3.51; 95% CI, 1.56-8.20 were associated with primary MDR TB. Among patients with primary MDR TB, 44 84.6% converted sputum cultures to negative. The rate of sputum culture conversion was lower among patients with diabetes adjusted hazard ratio aHR, 0.34; 95% CI, .13-.87 and among smokers aHR, 0.16; 95% CI, .04-.61. Conclusions.  We found diabetes was associated with an increased risk of primary MDR TB; both diabetes and smoking were associated with a longer time to sputum culture conversion.

Subjects: Health Sciences, Epidemiology - Health Sciences, Pathology - Health Sciences, Public Health - Research Funding: This study was supported in part by the National Institutes of Health NIH Fogarty International Center D43TW007124, NIH National Institute of Allergy and Infectious Diseases K23AI103044 and K24AI114444, Bethesda, Maryland; and the Atlanta Clinical and Translational Science Institute NIH-NCATS UL1TR000454, the Laney Graduate School of Emory University, and the Emory Global Health Institute Atlanta, GA.

Keywords: Georgia - MDR TB - culture conversion - diabetes - socioeconomic status -



Author: Argita D. Salindri, Maia Kipiani, Russell Kempker, Neel Gandhi, Lasha Darchia, Nestani Tukvadze, Henry Blumberg, Matthew Magee,

Source: https://open.library.emory.edu/



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