Factors predicting 2-month culture positivity in smear-positive pulmonary tuberculosis - 24/12/25
, Mallorie Kerjouan a, Delphine Bachelet b, Stéphane Jouneau a, c, Charles Ricordel a, Cédric Laouenan b, Nathalie De Castro d, Pierre Tattevin eHighlights |
• | Cough and sputum production during two-month follow-up was associated with positive M2 culture. |
• | Similar and reassuring treatment success rates were recorded in the two groups under consideration. |
• | It matters to be attentive to indications for prolonging treatment for three months. |
Abstract |
Introduction |
Failure to achieve sputum culture conversion after two months of treatment (M2) for pulmonary tuberculosis (TB) is associated with treatment failure. We aimed to identify the determinants of persistent culture-positive sputum at M2.
Methods |
We performed an ancillary study of the multicentric randomized trial FAST-TB, which enrolled adult patients with smear-positive rifampicin-susceptible pulmonary TB in France in 2014–2018.
Results |
Among the 203 patients enrolled in the FAST-TB study, 177 were evaluated at M2, including 104 with sputum culture: 82 (79 %) culture-negative, and 22 (21 %) culture-positive. Persistence of cough and sputum during follow-up was associated with culture positivity at M2: This was significant for sputum at different time points (respectively 84 % in culture-positive vs. 50 % in culture-negative at M1, 65 % vs. 37 % at M2, and 43 % vs. 17 % at M4, P < 0.05 for all), and for persistent cough at M4 (71 %, vs. 36 %, P = 0.006). Treatment success was similar between groups.
Conclusion |
The main predictors of culture-positive sputum at M2 in patients with smear-positive rifampicin-susceptible pulmonary TB are persistent cough and sputum during treatment. Systematic monitoring of these symptoms could contribute to early detection of patients who may require prolonged anti-TB treatment.
Le texte complet de cet article est disponible en PDF.Keywords : Cough, Sputum, Culture, Prolonged treatment
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Vol 56 - N° 1
Article 105220- janvier 2026 Retour au numéro
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