Daily cough frequency in tuberculosis and association with household infection
Daily cough frequency in tuberculosis and association with household infection
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DOI：
10.5588/ijtld.17.0652
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发表时间：
2018-08-01
影响因子：
4
通讯作者：
Bothamley, G. H.
中科院分区：
文献类型：
--
作者：
Turner, R. D.;Birring, S. S.;Bothamley, G. H.
背景：虽然结核病中的咳嗽被认为是传播的重要因素，但几乎没有客观的支持证据。目的：描述一组结核病患者的24小时咳嗽频率，并调查与家庭感染率的关系。设计：在开始抗结核治疗时或之前，对新诊断的肺结核患者进行24小时咳嗽频率测量。以潜在结核分枝杆菌感染(LTBI)组为对照。结果：44例肺结核患者的每日咳嗽频率是不同的(几何平均值[GM]174，四分位数范围[IQR]68-475咳嗽/24小时)，高于LTBI(n=17)；GM 19次/24小时，IQR 8-53；P<；0.001)，白天高于夜间(GM8.9咳嗽/小时，IQR4.1-19.0vs.GM2.9咳嗽/小时，IQR0.7-13.4；P<；0.0001)。此外，肺结核患者的24小时咳嗽频率与痰涂片状况有关(P=0.040)，而与吸烟无关(P=0.475)。多因素Logistic回归分析显示，接触者感染与指征病例数、痰涂片分级(P=0.014)和咳嗽次数(P=0.022)独立相关。结论：测定肺结核患者24小时咳嗽次数有助于预测肺结核的传染性和传播方式。
SETTING: Although cough in tuberculosis (TB) is presumed to be important for transmission, there is little objective supporting evidence.OBJECTIVE: To describe 24-h cough frequency in a group with TB, and investigate associations with household rates of infection.DESIGN: Patients with a new diagnosis of pulmonary TB underwent 24-h cough frequency measurement at or just before initiation of anti-tuberculosis treatment. A group with latent Mycobacterium tuberculosis infection (LTBI) acted as controls. Rates of infection among household contacts of sputum smear-positive TB were measured using the interferon-gamma release assay and the tuberculin skin test, and compared with variables relating to the contacts themselves, and to the index case, including cough frequency.RESULTS: Daily cough frequency in TB patients (n = 44) was variable (geometric mean [GM] 174, interquartile range [IQR] 68-475 coughs/24 h), higher than in LTBI (n = 17; GM 19 coughs/24 h, IQR 8-53; P < 0.001), and higher during the day than overnight (GM 8.9 coughs/h, IQR 4.1-19.0 vs. GM 2.9 coughs/h, IQR 0.7-13.4; P < 0.0001). Also, 24-h cough frequency in TB was associated with sputum smear status (P = 0.040), but not smoking (P = 0.475). Multivariable logistic regression confirmed that infection in contacts was independently associated with index case sputum smear grade (P = 0.014) and cough frequency (P = 0.022).CONCLUSION: Measurement of 24-h cough frequency in pulmonary TB helps predict infectiousness and transmission patterns.