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Sputum bacterial load predicts multidrug-resistant tuberculosis in retreatment patients: a case-control study
OBJECTIVE: To assess whether patient sputum bacterial load can be used to identify patients at increased risk of MDR-TB.
METHODS: We used a case-control study and multivariable logistic regression models to investigate associations between MDR-TB and sputum bacterial load, as measured by semi-quantitative microscopy and automated time to detection (TTD) of liquid culture. We assessed data from retreatment TB patients with MDR-TB (cases) and from those without MDR-TB (controls) at a reference laboratory in Cameroon.
RESULTS: MDR-TB was associated with a smear microscopy grade of 3+ (OR 21.9, 95%CI 6.2–76.8) or 2+ (OR 10.8, 95%CI 2.9–40.7), compared to a result of 1+, scanty or smear-negative among 80 MDR-TB cases and 521 controls. MDR-TB was associated with automated TTD of 160 h (OR 2.2, 95%CI 1.1–4.7) compared to >160 h among a subpopulation of 47 cases and 350 controls.
CONCLUSIONS: A higher sputum bacterial load is associated with MDR-TB in retreatment patients in Cameroon.
Keywords: MDR-TB; bacillary load; smear microscopy grade
Document Type: Research Article
Affiliations: 1: Tuberculosis Reference Laboratory Bamenda, Bamenda, German International Cooperation, Yaounde 2: Tuberculosis Reference Laboratory Bamenda, Bamenda 3: National Tuberculosis Control Programme, Yaounde 4: Independent Consultant, Yaounde, Cameroon 5: Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium, International Union Against Tuberculosis and Lung Disease, Paris, France 6: Institute of Ageing and Chronic Disease and School of Veterinary Science, University of Liverpool, Leahurst, UK
Publication date: 01 June 2016
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