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The following is a summary of “Time to sputum culture conversion and its associated factors among drug-resistant tuberculosis patients: a systematic review and meta-analysis,” published in the February 2024 issue of Infectious Diseases by Wenlu et al.

Researchers conducted a retrospective study to assess the duration of sputum culture conversion among patients with drug-resistant tuberculosis (DR-TB) and identify associated factors.

They conducted an electronic search across PubMed, The Cochrane Library, Embase, CINAHL, Web of Science, CNKI, Wan Fang, CBM, and VIP databases to gather relevant studies on sputum culture conversion time in patients with DR-TB. Meta-analysis was conducted using R version 4.3.0 and Stata 16 software.

The results showed that 45 studies involving 17,373 patients were included. Meta-analysis revealed a pooled median time to sputum culture conversion of 68.57 days (IQR 61.01, 76.12). Sputum culture conversion time varied across different WHO regions, countries with varying levels of development, and different treatment schemes. Factors associated with sputum culture conversion time in patients with drug-resistant tuberculosis included gender (aHR = 0.59, 95%CI: 0.46, 0.76), alcohol history (aHR = 0.70, 95%CI: 0.50, 0.98), smoking history (aHR = 0.58, 95%CI: 0.38, 0.88), history of second-line drug use (aHR = 0.64, 95%CI: 0.47, 0.87), BMI < 18.5 kg/m² (aHR = 0.69, 95%CI: 0.60, 0.80), presence of lung cavity (aHR = 0.70, 95%CI: 0.52, 0.94), and baseline sputum smear grading (Positive) (aHR = 0.56, 95%CI: 0.36, 0.87), (grade 1⁺) (aHR = 0.87, 95%CI: 0.77, 0.99), (grade 2⁺) (aHR = 0.81, 95%CI: 0.69, 0.95), (grade 3⁺) (aHR = 0.71, 95%CI: 0.61, 0.84).

Investigators concluded that DR-TB patients in wealthier regions and on bedaquiline convert faster. Factors like female sex, unhealthy habits, low BMI < 18.5 kg/m², lung cavities, and higher initial bacterial load may delay conversion.

Source: bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-024-09009-5