Relationship between chest radiographic characteristics, sputum bacterial load, and treatment outcomes in patients with extensively drug-resistant tuberculosis

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dc.contributor.authorTe Riele, J. B.en_ZA
dc.contributor.authorBuser, V.en_ZA
dc.contributor.authorCalligaro, G.en_ZA
dc.contributor.authorEsmail, A.en_ZA
dc.contributor.authorTheron, G.en_ZA
dc.contributor.authorLesosky, M.en_ZA
dc.contributor.authorDheda, K.en_ZA
dc.date.accessioned2021-10-21T13:14:50Z
dc.date.available2021-10-21T13:14:50Z
dc.date.issued2019
dc.descriptionCITATION: Te Riele, J. B., et al. 2019. Relationship between chest radiographic characteristics, sputum bacterial load, and treatment outcomes in patients with extensively drug-resistant tuberculosis. International Journal of Infectious Diseases, 79:65-71, doi:10.1016/j.ijid.2018.10.026.
dc.descriptionThe original publication is available at https://www.clinicalkey.com/
dc.description.abstractBackground: Data about the relationship between chest radiographs and sputum bacillary load, with treatment outcomes, in patients with extensively drug-resistant tuberculosis (XDR-TB) from HIV/TB endemic settings are limited. Methods: Available chest radiographs from 97 South African XDR-TB patients, at the time of diagnosis, were evaluated by two independent readers using a validated scoring system. Chest radiograph findings were correlated with baseline sputum bacillary load (smear-grade and culture time-to-positive in MGIT), and prospectively ascertained clinical outcomes (culture conversion and all-cause mortality). Results: Radiographic bilateral lung disease was present in 75/97 (77%). In the multivariate analysis only a higher total radiographic score (95% CI) was associated with higher likelihood of death [1.16 (1.05–1.28) p = 0.003], and failure to culture convert [0.85 (0.74–0.97) p = 0.02]. However, when restricting analyses to HIV-infected patients, disease extent, cavitation, and total radiographic scores were not associated with mortality or culture-conversion. Finally, cavitary, disease extent, and total radiographic scores all positively correlated with bacterial load (culture time-to-positive). Conclusions: In endemic settings, XDR-TB radiological disease extent scores are associated with adverse clinical outcomes, including mortality, in HIV uninfected persons. These data may have implications for clinical and programmatic decision-making and for evaluation of new regimens in clinical trials.en_ZA
dc.description.urihttps://www.clinicalkey.com/#!/content/playContent/1-s2.0-S1201971218345740?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1201971218345740%3Fshowall%3Dtrue&referrer=https:%2F%2Fpubmed.ncbi.nlm.nih.gov%2F
dc.description.versionPublisher's version
dc.format.extent7 pagesen_ZA
dc.identifier.citationTe Riele, J. B., et al. 2019. Relationship between chest radiographic characteristics, sputum bacterial load, and treatment outcomes in patients with extensively drug-resistant tuberculosis. International Journal of Infectious Diseases, 79:65-71, doi:10.1016/j.ijid.2018.10.026
dc.identifier.issn1201-9712 (online)
dc.identifier.otherdoi:10.1016/j.ijid.2018.10.026
dc.identifier.urihttp://hdl.handle.net/10019.1/123278
dc.language.isoen_ZAen_ZA
dc.publisherElsevieren_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectCavitary diseaseen_ZA
dc.subjectMultidrug-resistant tuberculosisen_ZA
dc.subjectExtensively drug-resistant tuberculosisen_ZA
dc.subjectRadiography, Medicalen_ZA
dc.subjectChest -- Examinationen_ZA
dc.subjectPulmonary respiration -- Diseasesen_ZA
dc.subjectObstructive Lung Diseaseen_ZA
dc.titleRelationship between chest radiographic characteristics, sputum bacterial load, and treatment outcomes in patients with extensively drug-resistant tuberculosisen_ZA
dc.typeArticleen_ZA
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