Factors influencing time to sputum conversion among patients with smear-positive pulmonary tuberculosis
Factors influencing time to sputum conversion among patients with smear-positive pulmonary tuberculosis
复制标题
DOI：
10.1086/513772
复制
发表时间：
1997-09-01
影响因子：
11.8
通讯作者：
Blum, S
中科院分区：
文献类型：
--
作者：
Telzak, EE;Fazal, BA;Blum, S
对于痰涂片阳性的肺结核或喉结核住院患者，疾病控制和预防中心建议在停止呼吸隔离之前，连续三次痰样本的抗酸杆菌（AFB）为阴性。有限的数据可用于预测获得三次阴性痰涂片和培养的时间长度，并确定与痰涂片和培养转换前的时间间隔延长相关的因素，特别是在感染人类免疫缺陷病毒（HIV）的患者中。对于100例连续的涂阳肺结核患者，计算从开始适当治疗到连续三次涂阴中的第一次涂阴的平均和中位天数，并确定相关的风险因素。在连续三次阴性痰涂片检查中，第一次阴性痰涂片检查前的平均天数为33天;中位数为23天。在逐步多元回归分析中，空洞性疾病、初始涂片上有大量AFB和既往无结核病史是与涂片和培养转换天数增加独立相关的因素。艾滋病毒不会延长传染期。
For hospitalized patients with smear-positive pulmonary or laryngeal tuberculosis, the Centers far Disease Control and Prevention recommends that three consecutive sputum samples be negative for acid-fast bacilli (AFB) before respiratory isolation is discontinued. Limited data are available to predict the length of time to obtain three negative sputum smears and cultures and to determine factors associated with a prolonged interval before sputum smear and culture conversion, especially among patients infected with human immunodeficiency virus (HIV). For 100 consecutive patients with smear-positive pulmonary tuberculosis, the mean and median numbers of days from the initiation of appropriate therapy to the first of three consecutive negative smears were calculated, and associated risk factors were determined. The mean number of days before the first of three consecutive negative sputum smears was 33 days; the median was 23 days. On stepwise multiple regression analysis, cavitary disease, numerous AFB on the initial smear, and no prior history of tuberculosis were the factors independently associated with an increased number of days for both smear and culture conversion. HIV does not prolong the period of infectiousness.