How soon should patients with smear-positive tuberculosis be released from inpatient isolation?
How soon should patients with smear-positive tuberculosis be released from inpatient isolation?
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DOI：
10.1086/649022
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发表时间：
2010-01
影响因子：
4.5
通讯作者：
Narita M
中科院分区：
文献类型：
--
作者：
Horne DJ;Johnson CO;Oren E;Spitters C;Narita M
确定肺结核患者痰涂片转化时间的预测因子可用于结核病患者的方案规划和咨询。基于危险因素的涂片转换时间估计可能会有所帮助。我们使用时间-事件分析确定与痰涂片转换时间相关的重要因素。我们使用比例风险模型进行了一项队列研究，以确定与涂片转换时间相关的因素。本文回顾了2003年和2004年西雅图和金县公共卫生结核病控制项目管理的所有痰涂阳肺结核病例。我们将痰涂片转化的时间定义为从治疗开始到持续转化的第一个日期所经过的时间。痰液AFB涂片阳性98例。双变量分析显示，较低的初始涂片分级（1+至4+等级）和胸片上没有空化与早期痰涂片转换相关。在多元回归分析中，初始涂片分级（风险比[HR] 0.45, 95%可信区间[CI] 0.35-0.57）和耐药性（风险比[HR] 2.30, 95% CI 1.08-4.89）仍然显著。在涂片转化之前进行培养转化不常见，除了最初的4+涂片患者（发生率为38%）。初始涂片分级是肺结核患者痰涂片和培养转化时间的最强预测因子，可能是方案规划和患者咨询的有用预测因子。
Identification of predictors of time to sputum smear conversion in patients with pulmonary tuberculosis (TB) could be used for programmatic planning and the counseling of TB patients. Time estimates of smear conversion based on the presence of risk factors may assist. We identify significant factors associated with time to sputum smear conversion using time-to-event analysis. We performed a cohort study using proportional hazards models to identify factors associated with time to smear conversion. All cases of sputum smear positive pulmonary TB managed by Public Health - Seattle & King County TB Control Program in 2003 and 2004 were reviewed. We defined the time to sputum smear conversion as the time elapsed from the start of treatment to the first date of sustained conversion. There were 98 patients whose sputum was AFB smear positive. Lower initial smear grade (on 1+ to 4+ scale), and absence of cavitation on chest radiograph were associated with earlier sputum smear conversion on bivariate analysis. In multiple regression analysis, initial smear grade (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.35–0.57) and drug resistance (HR 2.30, 95% CI 1.08–4.89) remained significant. Culture conversion preceding smear conversion was uncommon except for patients with initial 4+ smears (occurred in 38%). Initial smear grade was the strongest predictor of time to sputum smear and culture conversion in pulmonary TB patients and may be a useful predictor for programmatic planning and patient counseling.
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影响因子：
11.8
作者：
Sepkowitz KA
通讯作者：
Sepkowitz KA
影响因子：
11.8
作者：
Telzak, EE;Fazal, BA;Blum, S
通讯作者：
Blum, S
DOI：
10.1016/s0962-8479(96)90026-x
发表时间：
1996-04-01
期刊：
TUBERCLE AND LUNG DISEASE
影响因子：
--
作者：
Rieder, HL
通讯作者：
Rieder, HL
影响因子：
4.9
作者：
Mariam, DH;Mengistu, Y;Andersson, DI
通讯作者：
Andersson, DI
影响因子：
--
作者：
García-García, MD;Ponce-de-León, A;Small, PM
通讯作者：
Small, PM