Culture-negative TB: Clinical Characteristics, Risk Factors and Treatment Outcomes

F. Okoya, C. C. Huang, Z. Zhang, L. Lecca, R. Calderon, C. Contreras, R. M. Yataco, Jerome T. Galea, Mercedes Becerra, M. Murray

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Although culture remains the standard for TB diagnosis, 15–20% of patients diagnosed and treated for TB are culture-negative. We explored clinical characteristics, risk factors and treatment outcomes for culture-negative TB in a Peruvian cohort.

Methods: We recruited 4,500 index TB patients and 10,160 household contacts in Lima, Peru, and enrolled 692 secondary patients diagnosed with TB during follow-up of household contacts. We analyzed smear and culture status, sociodemographic factors, clinical characteristics and TB treatment outcomes to compare culture-negative and positive patients.

Results: Of the 4,880 adult patients, 915 (18.8%) were culture-negative. Culture-negative patients were less likely to report symptoms of TB disease and disease of longer duration. A multivariate analysis showed no statistically significant difference in loss to follow-up, treatment failure or recurrence between the culture-negative and -positive groups but a higher rate of death among culture-negative patients with an adjusted OR of 1.65 (95% CI 1.05–2.60). In a multivariate analysis of determinants of culture negativity, older age, substance use and being a secondary case were associated with culture status.

Conslusion: More recognition and awareness of culture-negative TB is key for early and correct diagnosis to reduce transmission and improve treatment outcomes.

Original languageAmerican English
JournalThe International Journal of Tuberculosis and Lung Disease
Volume27
DOIs
StatePublished - Jan 1 2023

Keywords

  • Culture Negativity
  • Treatment Outcomes
  • Tuberculosis

Disciplines

  • Social and Behavioral Sciences
  • Social Work

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