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Updated: Apr 11, 2026
The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
Published on: August 11, 2008
Factors Influencing Early Sputum Culture Conversion in Pulmonary Drug-resistant Tuberculosis
Udvass Kumar Kotokey1, Savitri Kumari2
1Department of Respiratory Medicine, National Institute of Tuberculosis and Respiratory Diseases (NITRD), New Delhi, India.
Introduction:
India bears the highest global burden of tuberculosis (TB), with multidrug-resistant TB (MDR-TB) posing substantial treatment challenges. Sputum culture conversion is a vital indicator of treatment response and an early predictor of success in drug-resistant TB (DR-TB). This study aimed to evaluate the time to early sputum culture conversion (within 6 months) in DR-TB patients and identify factors influencing this outcome across different resistance patterns: MDR, MDR with fluoroquinolone resistance, MDR with second-line injectable resistance, and extensively DR-TB (XDR-TB).
Methods:
This prospective cross-sectional observational study was conducted in India. Seventy-four DR-TB patients enrolled between January and October 2019 were assessed. Demographic data, comorbidities, and culture conversion times were analyzed using Chi-square tests and univariate logistic regression. P <0.05 was considered statistically significant.
Results:
Among the 74 patients (62.2% male; mean age 30 years), most MDR-TB patients (52%) achieved culture conversion within 3 months, while pre-XDR and XDR cases mostly converted within 2 months. Smoking (P = 0.03), low body mass index (BMI) (P = 0.025), cavitary lesions on chest X-ray (P = 0.01), and lower socioeconomic status (P = 0.02) were significantly associated with delayed conversion.
Conclusion:
Early sputum culture conversion is a key milestone in DR-TB treatment. Addressing modifiable risk factors such as smoking, undernutrition, and cavitary disease may improve outcomes. Further studies are needed to identify interventions to accelerate culture conversion and enhance treatment success.
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