Duration of Pulmonary Tuberculosis Infectiousness under Adequate Therapy, as Assessed Using Induced Sputum Samples

Tuberc Respir Dis (Seoul). 2017 Jan;80(1):27-34. doi: 10.4046/trd.2017.80.1.27. Epub 2016 Dec 30.

Abstract

Background: A sputum culture is the most reliable indicator of the infectiousness of pulmonary tuberculosis (PTB); however, a spontaneous sputum specimen may not be suitable. The aim of this study was to evaluate the infectious period in patients with non-drug-resistant (DR) PTB receiving adequate standard chemotherapy, using induced sputum (IS) specimens.

Methods: We evaluated the duration of infectiousness of PTB using a retrospective cohort design.

Results: Among the 35 patients with PTB, 22 were smear-positive. The rates of IS culture positivity from baseline to the sixth week of anti-tuberculosis medication in the smear-positive PTB group were 100%, 100%, 91%, 73%, 36%, and 18%, respectively. For smear-positive PTB cases, the median time of conversion to culture negativity was 35.0 days (range, 28.0-42.0 days). In the smear-negative PTB group (n=13), the weekly rates of positive IS culture were 100%, 77%, 39%, 8%, 0%, and 0%, respectively, and the median time to conversion to culture-negative was 21.0 days (range, 17.5-28.0 days).

Conclusion: The infectiousness of PTB, under adequate therapy, may persist longer than previously reported, even in patients with non-DR PTB.

Keywords: Induced Sputum; Infectious Disease Incubation Period; Mycobacterium tuberculosis; Tuberculosis, Pulmonary.