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KMID : 0383820070630050417
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Tuberculosis and Respiratory Diseases
2007 Volume.63 No. 5 p.417 ~ p.422
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Clinical Manifestations of Persistent Smear Positive and Culture Negative Sputum Tests 5 Months after First-Line Anti-Tuberculous Chemotherapy
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Kim Do-Hyung
Hwang Su-Hee
Jeon Doo-Soo
Min Jin-Hong
Kang Hyung-Seok
Park Seung-Kyu
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Abstract
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Background : It is not known with certainty whether patients with persistently positive sputum smear results who
have also had negative sputum culture results require prolongation of treatment for tuberculosis in order to avoid
an increased risk of eventual relapse. The purpose of the present study was to retrospectively describe the treatment
characteristics and evaluate the appropriate duration of treatment in these patients.
Methods : Sixty of 69 patients with sputum smear positive and culture negative tests at 5 months after first line
anti-tuberculous chemotherapy from 2002 to 2003 were retrospectively analyzed. Exclusion criteria included
incomplete treatment or resistance to rifampicin or two additional antibiotics, as determined by a drug susceptibility
test (DST).
Results : Smear conversion of the study subjects was observed after 8.3±2.3 months treatment, and the patients
were culture negative after 2.0±0.8 months. The relapse rates of the study subjects were 3.8, 10.0, and 25.8%
after 1, 2, and 5 years of anti-tuberculosis chemotherapy, respectively. The relapse rates were not significantly
affected by a series of risk factors such as age, sex, presence of diabetes, a sputum culture examination after
2 months treatment, previous treatment history, chest radiograph, and duration of the treatment (P＞0.05).
Conclusion : Regimen change is not required for patients with persistent smear positive but culture negative tests
in the fifth month for first line antituberculous treatment. However, a further study will be needed to clarify the
high relapse rate in this specific group of patients.
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KEYWORD
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Pulmonary tuberculosis, Acid-fast bacilli, Relapse
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