Journal Article

Factors Influencing Time to Sputum Conversion Among Patients with Smear-Positive Pulmonary Tuberculosis

Edward E. Telzak, Barkat A. Fazal, Cathy L. Pollard, Glenn S. Turett, Jessica E. Justman and Steve Blum

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 3, pages 666-670
Published in print September 1997 | ISSN: 1058-4838
Published online September 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/513772
Factors Influencing Time to Sputum Conversion Among Patients with Smear-Positive Pulmonary Tuberculosis

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For hospitalized patients with smear-positive pulmonary or laryngeal tuberculosis, the Centers for 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.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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